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General NPI Number Information
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NPI Number | 1326559220
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Entity Type | Organization
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Legal Business Name | ALEUTIAN FAMILY DENTISTRY, INC.
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 159 RIVERSIDE DRIVE
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City | UNALASKA
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State | AL
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Zip | 99685
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Country | US
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Telephone | 907-581-3122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1010
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City | UNALASKA
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State | AK
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Zip | 99685-1010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. ROBERT XAVIER MACARTHUR IV
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Credential | DMD, MPH
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Telephone | 907-519-9757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 104564
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License Number State | AK
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