| Exindent | |
|
130 Carlanna Lake Rd Ketchikan AK 99901-5669 | |
| (832) 726-6655 | |
| Not Available |
| Full Name | Exindent |
|---|---|
| Speciality | Dentist |
| Location | 130 Carlanna Lake Rd, Ketchikan, Alaska |
| Authorized Official Name and Position | Peter Adams Emmons (DENTIST) |
| Authorized Official Contact | 8327266655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Exindent 1342 N 650 E Tooele UT 84074-9848 Ph: (832) 726-6655 | Exindent 130 Carlanna Lake Rd Ketchikan AK 99901-5669 Ph: (832) 726-6655 |
| NPI Number | 1639534696 |
|---|---|
| Provider Enumeration Date | 12/17/2015 |
| Last Update Date | 12/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639534696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 105109 (Alaska) | Primary |
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Ketchikan Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Carlanna Lake Rd, Ketchikan, AK 99901 Phone: 909-967-8052 Fax: 907-331-4220 |