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Oral and Maxillofacial Surgery

Fairbanks, Alaska

Provider NPI: 1922325943

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 907-374-8111  Fax: 907-374-8119

Business Mailing Address:
Tel: 907-978-1535  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y1223S0112XDental Providers
Oral and Maxillofacial Surgery


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