Four Corners Dental Group Fairbanks

NPI 1710310073 - Dentist - 1223G0001X

NPI Details
NPI 1710310073
Enumeration Date 08/09/2013
Last Updated 08/09/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name SHANE D SHANE
Position DENTIST
Phone (907) 479-7771
Fax (907) 479-7772
Practice Location
3487 AIRPORT WAY
FAIRBANKS AK, 99709-4761, US
Phone (907) 479-7771
Fax (907) 479-7772
Business Location
3487 AIRPORT WAY
FAIRBANKS AK, 99709-4761, US
Phone (907) 479-7771
Fax (907) 479-7772
Toxanomy
Taxonomy Code 1223G0001X
License State Alaska
License Number 1262
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According to our database, Four Corners Dental Group Fairbanks NPI is 1710310073, taxonomy code is 1223G0001X and license number is 1262, license state is located at Alaska. Four Corners Dental Group Fairbanks physically located at 3487 Airport Way, Fairbanks AK, 99709-4761. NPI Number 1033115704 has the healthcare provider type.

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1710310073 NPI number is provided on an as is basis without warranty of any kind. 1710310073 is maintained by the National Plan & Provider Enumeration System. The contents of Four Corners Dental Group Fairbanks are for informational purposes only.