Southcentral Foundation

NPI #1396292298 in Iliamna, Alaska

Provider Information

NPI Number
1396292298
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 5, 2023

Practice Location

Address
101 AIRPORT ROAD
State
Alaska
ZIP Code
99606
Phone
(907) 571-1818

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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