| Fairbanks Family Dental Care Inc | |
|
515 7th Ave Suite 220 Fairbanks AK 99701-4933 | |
| (907) 452-8296 | |
| Not Available |
| Full Name | Fairbanks Family Dental Care Inc |
|---|---|
| Speciality | Dentist |
| Location | 515 7th Ave, Fairbanks, Alaska |
| Authorized Official Name and Position | Todd S Christensen (PRESIDENT) |
| Authorized Official Contact | 9074528296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairbanks Family Dental Care Inc 515 7th Ave Suite 220 Fairbanks AK 99701-4933 Ph: (907) 452-8296 | Fairbanks Family Dental Care Inc 515 7th Ave Suite 220 Fairbanks AK 99701-4933 Ph: (907) 452-8296 |
| NPI Number | 1225373947 |
|---|---|
| Provider Enumeration Date | 12/06/2012 |
| Last Update Date | 12/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225373947 | NPI | - | NPPES |
| DD0027 | Medicaid | AK | |
| DD0085 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Alaska) | Primary |
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