Individual provider · NPI-1

Mary Chimiugak

Dental Therapist · Bethel, AK

NPI number1023874583
StatusActive
Last updated in NPPESFeb 22, 2024

Details

NPI
1023874583
Entity type
Individual (NPI-1)
Name
Mary Chimiugak
Sex
Female
Sole proprietor
No
Enumeration date
Feb 22, 2024
Certification date
Feb 20, 2024
Last updated
Feb 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
125J00000X Dental Therapist24-179-DHATAKYes

Practice location

700 Chief Eddie Hoffman Hwy
Bethel, AK 99559-3427

Phone 907-543-6319

Mailing address

Po Box 3427
Bethel, AK 99559-3427

Phone 907-543-6319

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