Petersburg Dental, Inc.

NPI #1932543345 in Petersburg, Alaska

Provider Information

NPI Number: 1932543345
Entity Type: Organization
Organization Name: Petersburg Dental, Inc.
Primary Specialty: Dentist
Enumeration Date: Apr 29, 2013
Last Updated: Apr 29, 2013

Practice Location

Address: 806 S. NORDIC DR.
City: Petersburg
State: Alaska
ZIP Code: 99833-0469
Phone: (907) 772-9246

Authorized Official

Name: JAY LISTER
Title: DDS/PRESIDENT
Phone: (907) 772-9246

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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