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Southcentral Foundation
Dental Clinic/Center in Port Alsworth, Alaska
NPI 1114480167

Southcentral Foundation is a Dental Clinic/Center based in Seattle, AK and is specialized in Dental. Southcentral Foundation practices in Port Alsworth, AK. The NPI Number for Southcentral Foundation is 1114480167 and holds a License No. (Alaska).

The current practice location address for Southcentral Foundation is 1 Flight Line Rd, Port Alsworth, AK and can be reached out via phone at 907-781-2256.

Location: 1 Flight Line Rd, Port Alsworth, AK, 98124-5151
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1114480167
Provider Name
Southcentral Foundation
Credential
Provider Entity Type
Organization
Address
1 Flight Line Rd, Port Alsworth, AK, 98124-5151
Phone Number
907-781-2256
Fax Number
Provider Enumeration Date
04/08/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1695503 05 AK
institution
Provider Business Practice Location Address Details
Address
1 Flight Line Rd
City
Port Alsworth
State
Alaska
Zip
99653-9801
Phone Number
907-781-2256
Fax Number
person
Provider Business Mailing Address Details
Address
1 Flight Line Rd
City
Port Alsworth
State
Alaska
Zip
99653-9801
Phone Number
907-781-2256
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
()
Definition
Definition to come...
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