Lakeview Professional Dental Associates Inc.

NPI #1720116601 in Wasilla, Alaska

Provider Information

NPI Number: 1720116601
Entity Type: Organization
Organization Name: Lakeview Professional Dental Associates Inc.
Primary Specialty: Dentist
Enumeration Date: Mar 1, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 851 WESTPOINT DR
Address 2: SUITE 112
City: Wasilla
State: Alaska
ZIP Code: 99654-7142
Phone: (907) 376-4415

Authorized Official

Name: JEAN KINGSLIEN
Title: DIRECTOR SECRETARY TREASURER
Phone: (907) 346-2625

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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