Southcentral Foundation

NPI #1497202550 in Mcgrath, Alaska

Provider Information

NPI Number
1497202550
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 7, 2016
Last Updated
Sep 13, 2023

Practice Location

Address
10 TAKOTNA AVE
State
Alaska
ZIP Code
99627
Phone
(907) 524-3299

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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