Northern Dentistry Inc.

NPI #1487197463 in Wasilla, Alaska

Provider Information

NPI Number: 1487197463
Entity Type: Organization
Organization Name: Northern Dentistry Inc.
Primary Specialty: Dentist
Enumeration Date: Nov 23, 2016
Last Updated: Nov 23, 2016

Practice Location

Address: 951 E BOGARD RD
Address 2: STE. #203
City: Wasilla
State: Alaska
ZIP Code: 99654-7175
Phone: (907) 376-2456

Authorized Official

Name: CHARLES R. CORDOVA JR., DDS
Title: PRESIDENT
Phone: (702) 869-4435

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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