Southcentral Foundation
Southcentral Foundation is a General Practice Dentistry in Iliamna, Alaska. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 3
Practice location Address checks out
101 Airport RdIliamna, AK 99606
Phone: (907) 571-1818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X |
|---|---|
| General Practice Dentistry | Taxonomy 1223G0001X |
| Dental Therapist | Taxonomy 125J00000X |
Record details
| NPI number | 1750961918 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Southcentral Foundation |
| Authorized official | Ronald Olson — Executive Vice President Finance · (907) 729-4939 |
| Other names | Dental- Nilavena Dental Clinic; Dental- Nilavena Dental Clinic |
| NPI enumerated | April 12, 2021 |
| Last updated in NPPES | September 15, 2023 |
| Certification date | September 14, 2023 |
| Mailing address | Po Box 35151, Seattle, WA 98124-5151 |
Other providers in Iliamna
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Southcentral Foundation
101 Airport Rd, Iliamna, AK 99606 · (907) 571-1818