Healthcare Provider Details

I. General information

NPI: 1346501426
Provider Name (Legal Business Name): DENTAL ASSOCIATES OF ALASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E TUDOR RD STE 201
ANCHORAGE AK
99507-1050
US

IV. Provider business mailing address

1600 E TUDOR RD STE 201
ANCHORAGE AK
99507-1050
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-1228
  • Fax: 907-563-8654
Mailing address:
  • Phone: 907-561-1228
  • Fax: 907-563-8654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number395
License Number StateAK

VIII. Authorized Official

Name: DR. WILLIAM C. SCHLANSKER
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 907-561-1228