Jonathan Oudin, Dds, Llc | |
1700 E Bogard Rd Ste A201 Wasilla AK 99654-6569 | |
(907) 373-8455 | |
(907) 373-8456 |
Full Name | Jonathan Oudin, Dds, Llc |
---|---|
Speciality | Dentist - General Practice |
Location | 1700 E Bogard Rd Ste A201, Wasilla, Alaska |
Authorized Official Name and Position | Jonathan Oudin (OWNER) |
Authorized Official Contact | 2143170521 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Jonathan Oudin, Dds, Llc 1700 E Bogard Rd Ste A201 Wasilla AK 99654-6569 Ph: (907) 373-8455 | Jonathan Oudin, Dds, Llc 1700 E Bogard Rd Ste A201 Wasilla AK 99654-6569 Ph: (907) 373-8455 |
NPI Number | 1265167522 |
---|---|
Provider Enumeration Date | 07/20/2022 |
Last Update Date | 07/20/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265167522 | NPI | - | NPPES |
1574946 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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