| Southeast Alaska Regional Health Consortium | |
|
215 Front St Wrangell AK 99929 | |
| (907) 874-3731 | |
| (907) 874-3531 |
| Full Name | Southeast Alaska Regional Health Consortium |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 215 Front St, Wrangell, Alaska |
| Authorized Official Name and Position | Daniel Harris (VP/CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9074634000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Alaska Regional Health Consortium 3100 Channel Drive Ste 300 Attn: Provider Enrollment Juneau AK 99801 Ph: (907) 463-4000 | Southeast Alaska Regional Health Consortium 215 Front St Wrangell AK 99929 Ph: (907) 874-3731 |
| NPI Number | 1205372885 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 12/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205372885 | NPI | - | NPPES |
| 1663271 | Medicaid | AK | |
| 70206 | Other | AK | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Drs Moorhead& Ross Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Front St, Wrangell, AK 99929 Phone: 907-874-3731 Fax: 907-874-3531 |