| Keguta Dental Llc | |
| 
					660 Third Ave Ste C Bethel AK 99559-0169  | |
| (907) 545-3996 | |
| Not Available | 
| Full Name | Keguta Dental Llc | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 660 Third Ave Ste C, Bethel, Alaska | 
| Authorized Official Name and Position | Edwin H Allgair (DENTAL DIRECTOR/MANAGER) | 
| Authorized Official Contact | 2064190787 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Keguta Dental Llc Po Box 1051 Sterling AK 99672-1051 Ph: (206) 419-0787  | Keguta Dental Llc 660 Third Ave Ste C Bethel AK 99559-0169 Ph: (907) 545-3996  | 
| NPI Number | 1578999306 | 
|---|---|
| Provider Enumeration Date | 09/25/2013 | 
| Last Update Date | 08/20/2014 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1578999306 | NPI | - | NPPES | 
| 1608341 | Medicaid | AK | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D997 (Alaska) | Primary | 
Yukon Kuskokwim Health Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 829 Chief Eddie Hoffman Hwy, Ste 340, Bethel, AK 99559 Phone: 907-543-6000 Fax: 907-543-6117  | |
Yukon Kuskokwim Health Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 829 Chief Eddie Hoffman Hwy, Suite 340, Bethel, AK 99559 Phone: 907-543-6000 Fax: 907-543-6117  |