| Ketchikan Indian Corporation | |
|
2960 Tongass Ave Ketchikan AK 99901-5742 | |
| (907) 228-9200 | |
| (800) 887-8796 |
| Full Name | Ketchikan Indian Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2960 Tongass Ave, Ketchikan, Alaska |
| Authorized Official Name and Position | Steve F Hudson (HEALTH ADMINISTRATOR) |
| Authorized Official Contact | 9072289253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketchikan Indian Corporation 2960 Tongass Ave Ketchikan AK 99901-5742 Ph: (907) 228-9200 | Ketchikan Indian Corporation 2960 Tongass Ave Ketchikan AK 99901-5742 Ph: (907) 228-9200 |
| NPI Number | 1396153649 |
|---|---|
| Provider Enumeration Date | 07/31/2014 |
| Last Update Date | 07/31/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396153649 | NPI | - | NPPES |
| 378 | Other | AK | BUSINESS PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 378 (Alaska) | Primary |
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Exindent Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Carlanna Lake Rd, Ketchikan, AK 99901 Phone: 832-726-6655 |