NPI 1013084680

Fairbanks Orthodontic Group a Prof Corp

Organisation Orthodontics and Dentofacial Orthopedics Dentistry Fairbanks, AK

Practice location

Address: 1919 Lathrop St Suite 102, Fairbanks, AK 99701
Phone: (907) 452-2939
Fax: (907) 451-7330

Authorised official

Name: Walt Babula
Title: President Orthodontist
Phone: (907) 452-2939

Registered specialties (2)

Orthodontics and Dentofacial Orthopedics Dentistry Primary

Dental Providers Taxonomy 1223X0400X Licence AK9 (AK)

Other Dentist providers in Alaska →

Dentist

Dental Providers Taxonomy 122300000X Licence AK330 (AK)

Registry record

NPI: 1013084680
Entity type: Organization
NPI issued: 29 Nov 2006
Record last updated: 7 Aug 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.