| Southeast Alaska Regional Health Consortium | |
|
15 W Excel Petersburg AK 99833 | |
| (907) 772-3320 | |
| Not Available |
| Full Name | Southeast Alaska Regional Health Consortium |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15 W Excel, Petersburg, 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 |
|---|---|
| Southeast Alaska Regional Health Consortium 3100 Channel Dr Ste 300 Juneau AK 99801-7837 Ph: (907) 463-4074 | Southeast Alaska Regional Health Consortium 15 W Excel Petersburg AK 99833 Ph: (907) 772-3320 |
| NPI Number | 1235717844 |
|---|---|
| Provider Enumeration Date | 04/02/2021 |
| Last Update Date | 04/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235717844 | NPI | - | NPPES |
| 70206 | Other | AK | STATE OF ALASKA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Petersburg Dental, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 S. Nordic Dr., Petersburg, AK 99833 Phone: 907-772-9246 Fax: 907-772-9278 |