Southcentral Foundation

NPI #1487121331 in Chugiak, Alaska

Provider Information

NPI Number
1487121331
Entity Type
Organization
Organization Name
Southcentral Foundation
Subpart
Yes (part of a larger organization)
Parent Organization
SOUTHCENTRAL FOUNDATION
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Oct 30, 2018
Last Updated
Oct 10, 2023

Practice Location

Address
26341 EKLUTNA VILLAGE RD
State
Alaska
ZIP Code
99567-5148
Phone
(907) 688-6031

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice
Clinic/Center - DentalDental

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