Fairbanks Orthodontic Group a Prof Corp

NPI #1013084680 in Fairbanks, Alaska

Provider Information

NPI Number
1013084680
Entity Type
Organization
Organization Name
Fairbanks Orthodontic Group a Prof Corp
Primary Specialty
Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date
Nov 29, 2006
Last Updated
Aug 7, 2013

Practice Location

Address
1919 LATHROP ST
Address 2
SUITE 102
State
Alaska
ZIP Code
99701
Phone
(907) 452-2939

Authorized Official

Name
DR. WALT BABULA, DMD MSCO
Title
PRESIDENT ORTHODONTIST
Phone
(907) 452-2939

Specialties & Taxonomy Codes

Specialty
Dentist
Dentist - Orthodontics and Dentofacial OrthopedicsOrthodontics and Dentofacial Orthopedics

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