Preventive Dental Services, a Professional Corporation

NPI #1922341734 in Homer, Alaska

Provider Information

NPI Number: 1922341734
Entity Type: Organization
Organization Name: Preventive Dental Services, a Professional Corporation
Primary Specialty: Dentist
Enumeration Date: Mar 29, 2013
Last Updated: Mar 29, 2013

Practice Location

Address: 549 GRUBSTAKE AVE
Address 2: SUITE #A
City: Homer
State: Alaska
ZIP Code: 99603-7640
Phone: (907) 235-1286

Authorized Official

Name: DR. SUSAN JEANNE POLIS, D.D.S. , R.D.H
Title: DENTIST
Phone: (907) 235-1286

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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