Southcentral Foundation

NPI #1871175455 in Anchorage, Alaska

Provider Information

NPI Number: 1871175455
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: Apr 23, 2021
Last Updated: Sep 18, 2023

Practice Location

Address: 3801 UNIVERSITY LAKE DR
City: Anchorage
State: Alaska
ZIP Code: 99508-4658
Phone: (907) 729-2000

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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