Blue Phoenix Dental LLC

NPI #1134885593 in Unalaska, Alaska

Provider Information

NPI Number: 1134885593
Entity Type: Organization
Organization Name: Blue Phoenix Dental LLC
Primary Specialty: Dentist
Enumeration Date: Nov 10, 2021
Last Updated: Nov 10, 2021

Practice Location

Address: 159 RIVERSIDE DRIVE
City: Unalaska
State: Alaska
ZIP Code: 99685
Phone: (907) 545-1191

Authorized Official

Name: DR. SEAN MICHAEL DAVIS, DDS
Title: DENTIST
Phone: (907) 545-1191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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