NPI 1124603733

Southcentral Foundation

Organisation General Practice Dentistry Wasilla, AK

Practice location

Address: 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083
Phone: (907) 631-7690
Mailing address: PO Box 35151, Seattle, WA 98124-5151

Authorised official

Name: Ronald Lee Olson
Title: Executive Vice President Finance
Phone: (907) 729-4939

Registered specialties (3)

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X

Other Dentist providers in Alaska →

Multi-Specialty Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM1300X

Other Clinic/Center providers in Alaska →

Medical Specialty Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM2500X

Registry record

NPI: 1124603733
Entity type: Organization
NPI issued: 15 Mar 2021
Record last updated: 5 Jun 2026

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.