TUNDRA KIDS DENTISTRY LLC; NPI #1487025268

Contact Information

TUNDRA KIDS DENTISTRY LLC

1000 GREG KRUSCHEK AVE.
NOME, AK 99762

Phone: 907-443-3309
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Pediatric Dentistry	1223P0221X

Indicates primary specialty

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NPI Profile & details for TUNDRA KIDS DENTISTRY LLC

NPI Number 1487025268

LBN Legal business name TUNDRA KIDS DENTISTRY LLC

Authorized official CHRISTINE ROALOFS - (PEDIATRIC DENTIST)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/19/2015

Last updated 10/19/2015 - About 11 years ago

Identifiers

License #

1003

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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