| Dental Group | |
|
6000 Kanakanak Rd Dillingham AK 99576 | |
| (907) 842-5201 | |
| (907) 842-9250 |
| Full Name | Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6000 Kanakanak Rd, Dillingham, Alaska |
| Authorized Official Name and Position | Robert Clark (CEO) |
| Authorized Official Contact | 9078425201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Group Po Box 130 Dillingham AK 99576-0130 Ph: (907) 842-5201 | Dental Group 6000 Kanakanak Rd Dillingham AK 99576 Ph: (907) 842-5201 |
| NPI Number | 1770782831 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 04/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770782831 | NPI | - | NPPES |
| GR0175 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Lake Road Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4622 Shannon Lake Rd, Dillingham, AK 99576 Phone: 907-842-2324 |