Individual
DR. THOMAS RUSSELL BIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11723 OLD GLENN HWY, SUITE #207, EAGLE RIVER, AK 99577-7733
(907) 694-8610
(907) 694-8626
Mailing address
11723 OLD GLENN HWY, SUITE #207, EAGLE RIVER, AK 99577-7750
(907) 694-8610
(907) 694-8626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
387
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0387
—
AK
Enumeration date
11/29/2006
Last updated
07/08/2007
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