| Northern Lights Dental Anesthesia, Llc | |
|
1231 W Northern Lights Blvd Ste 623 Anchorage AK 99503-2337 | |
| (907) 268-3109 | |
| Not Available |
| Full Name | Northern Lights Dental Anesthesia, Llc |
|---|---|
| Speciality | Dentist - Dentist Anesthesiologist |
| Location | 1231 W Northern Lights Blvd, Anchorage, Alaska |
| Authorized Official Name and Position | Kenley Dane Michaud (CEO) |
| Authorized Official Contact | 9072683109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Lights Dental Anesthesia, Llc 1231 W Northern Lights Blvd Ste 623 Anchorage AK 99503-2337 Ph: (907) 268-3109 | Northern Lights Dental Anesthesia, Llc 1231 W Northern Lights Blvd Ste 623 Anchorage AK 99503-2337 Ph: (907) 268-3109 |
| NPI Number | 1437568409 |
|---|---|
| Provider Enumeration Date | 08/04/2014 |
| Last Update Date | 08/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437568409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | 1547 (Alaska) | Primary |
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