Southcentral Foundation

NPI #1124575022 in Nikolai, Alaska

Provider Information

NPI Number
1124575022
Entity Type
Organization
Organization Name
Southcentral Foundation
Subpart
Yes (part of a larger organization)
Parent Organization
SOUTHCENTRAL FOUNDATION
Primary Specialty
Dentist - General Practice
Enumeration Date
Sep 8, 2016
Last Updated
Sep 1, 2023

Practice Location

Address
9105 AIRPORT DRIVE
State
Alaska
ZIP Code
99691
Phone
(907) 293-2328

Authorized Official

Name
RONALD LEE OLSEN
Title
EXECUTIVE VICE PRESIDENT FINANCE
Phone
(907) 729-4939

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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