| Eagle Summit Dental Group | |
|
13015 Old Glenn Hwy #200 Eagle River AK 99577 | |
| (907) 694-8234 | |
| (907) 697-8225 |
| Full Name | Eagle Summit Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 13015 Old Glenn Hwy, Eagle River, Alaska |
| Authorized Official Name and Position | Michael Roland Sanders (PRESIDENT) |
| Authorized Official Contact | 9076948234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Summit Dental Group 13015 Old Glenn Hwy #200 Eagle River AK 99577-8080 Ph: (907) 694-8234 | Eagle Summit Dental Group 13015 Old Glenn Hwy #200 Eagle River AK 99577 Ph: (907) 694-8234 |
| NPI Number | 1629214705 |
|---|---|
| Provider Enumeration Date | 12/19/2008 |
| Last Update Date | 11/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629214705 | NPI | - | NPPES |
| 1086 | Other | AK | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1086 (Alaska) | Primary |
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