SUMMIT ORAL SURGERY LLC NPI 1174709927

NPI Information

SUMMIT ORAL SURGERY LLC is an oral and maxillofacial surgery dentist in Wasilla, AK. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SUMMIT ORAL SURGERY LLC NPI is 1174709927. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1700 E BOGARD RD STE B202
WASILLA, AK
ZIP 99654-570
Phone: (907) 357-3414
Fax: (907) 357-3714

The provider's authorized official is Matthew Anthony Welch .
The authorized official title is Member and has the following contact phone number (907) 357-3414.

The enumeration date for this NPI number is 1/10/2008 and was last updated on 1/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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