| Meridian Park Oral Surgery | |
|
3465 E Meridian Park Loop Suite A Wasilla AK 99654-7264 | |
| (907) 373-6670 | |
| (908) 312-2525 |
| Full Name | Meridian Park Oral Surgery |
|---|---|
| Speciality | Dentist |
| Location | 3465 E Meridian Park Loop, Wasilla, Alaska |
| Authorized Official Name and Position | Matthew Monaco (OWNER) |
| Authorized Official Contact | 9073736670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Park Oral Surgery 3465 E Meridian Park Loop Suite A Wasilla AK 99654-7264 Ph: (907) 373-6670 | Meridian Park Oral Surgery 3465 E Meridian Park Loop Suite A Wasilla AK 99654-7264 Ph: (907) 373-6670 |
| NPI Number | 1235679515 |
|---|---|
| Provider Enumeration Date | 03/06/2017 |
| Last Update Date | 03/06/2017 |
| Medicare PECOS PAC ID | 7810264603 |
|---|---|
| Medicare Enrollment ID | O20170526001241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235679515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Alaska) | Primary |
| Provider Name | Matthew A Monaco |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1235131392 PECOS PAC ID: 7416026661 Enrollment ID: I20080514000624 |
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