| Oral Surgery Associates Of Alaska | |
|
111 W 16th Ave Suite 203 Anchorage AK 99501-6206 | |
| (907) 561-1430 | |
| (907) 561-2697 |
| Full Name | Oral Surgery Associates Of Alaska |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 111 W 16th Ave, Anchorage, Alaska |
| Authorized Official Name and Position | William Randy Deeter (PRESIDENT) |
| Authorized Official Contact | 9075611430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Surgery Associates Of Alaska 111 W 16th Ave Suite 203 Anchorage AK 99501-6206 Ph: (907) 561-1430 | Oral Surgery Associates Of Alaska 111 W 16th Ave Suite 203 Anchorage AK 99501-6206 Ph: (907) 561-1430 |
| NPI Number | 1346254851 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 04/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346254851 | NPI | - | NPPES |
| DDG001 | Medicaid | AK | |
| 1518402 | Other | AK | UNITED CON ID |
| GRO153 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 18698 (Alaska) | Primary |
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