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NPI Code Detail

MEDICARE: THE LIBBY GROUP L.L.C.

MEDICARE: THE LIBBY GROUP L.L.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist1469AK

General Provider Information

NPI Number : 1487033510
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE LIBBY GROUP L.L.C.
Provider Business Mailing Address
First Line : 3920 LAKE OTIS PKWY STE A
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5210
Country : US
Telephone Number : 907-274-2659
Fax Number : 907-277-4782
Provider Business Practice Location Address
First Line : 3920 LAKE OTIS PKWY STE A
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5210
Country : US
Telephone Number : 907-274-2659
Fax Number : 907-277-4782
Authorized Official
Title or Position : DENTIST
Name : DR. JUSTIN CHRISTOPHER LIBBY
Credential : D.D.S.
Telephone Number : 907-274-2659
Provider Enumeration Date : 05/21/2015
Last Update Date : 05/21/2015

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Directions to “THE LIBBY GROUP L.L.C. ” Practice Location

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