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Individual

CORRINA LYNN CADZOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
11-070-DHAT

Contact information

Practice address
EAST 7TH AVE, FORT YUKON, AK 99740
(907) 662-2460
(907) 662-2709
Mailing address
PO BOX 309, FORT YUKON, AK 99740-0309
(907) 662-2460
(907) 662-2709

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
11-070-DHAT
AK
247200000X
Other Technician
11-070-DHAT
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11-070-DHAT
AK
Enumeration date
11/29/2011
Last updated
03/01/2012
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