| South East Alaska Regional Health Consortium | |
|
230 Dalton Street Ste 102 Haines AK 99827-9982 | |
| (907) 766-6372 | |
| (907) 766-2581 |
| Full Name | South East Alaska Regional Health Consortium |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 230 Dalton Street, Haines, Alaska |
| Authorized Official Name and Position | Daniel Harris (SR. VP / CFO) |
| Authorized Official Contact | 9074634000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South East Alaska Regional Health Consortium 3100 Channel Dr Ste 300 Juneau AK 99801-7837 Ph: (907) 463-4074 | South East Alaska Regional Health Consortium 230 Dalton Street Ste 102 Haines AK 99827-9982 Ph: (907) 766-6372 |
| NPI Number | 1508902529 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 06/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508902529 | NPI | - | NPPES |
| 1003869 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 70206 (Alaska) | Primary |