Organization · Type 2 NPI

Southcentral Foundation

General Practice Dentistry · Nondalton, AK

NPI number 1013464916 Active

Practice location

69 Main Street
Nondalton, AK 99640

Call (907) 294-2238 Map

Fax (907) 294-2240

Mailing address

PO Box 35151
Seattle, WA 98124-5151

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	20467 (AK)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4 other providers at this address

NPI record

NPI: 1013464916
Entity type: Organization (Type 2)
Issued: Sep 8, 2016
Last updated: Aug 31, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
Dental- Nondalton Dental Clinic · doing business as
Nondalton Dental Clinic · doing business as
Nondalton Dental Clinic · doing business as

Authorized official

Lee Olson
Executive Vice President Finance
(907) 729-4939

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013464916

Southcentral Foundation's National Provider Identifier is 1013464916, issued on Sep 8, 2016. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Nondalton, AK. The record was last updated on Aug 31, 2023.