| Frontier Dental, Llc | |
|
3650 Lake Otis Pkwy Ste 102 Anchorage AK 99508-5218 | |
| (907) 563-3820 | |
| Not Available |
| Full Name | Frontier Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3650 Lake Otis Pkwy, Anchorage, Alaska |
| Authorized Official Name and Position | Ken Oldham (DENTIST) |
| Authorized Official Contact | 9075635820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontier Dental, Llc 3650 Lake Otis Pkwy Ste 102 Anchorage AK 99508-5218 Ph: (907) 563-5820 | Frontier Dental, Llc 3650 Lake Otis Pkwy Ste 102 Anchorage AK 99508-5218 Ph: (907) 563-3820 |
| NPI Number | 1164685806 |
|---|---|
| Provider Enumeration Date | 07/02/2008 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164685806 | NPI | - | NPPES |
| DD7070 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | AA707 (Alaska) | Primary |
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