Individual provider · NPI-1

Kathrine G.D.A Levi

Dental Therapist · Bethel, AK

NPI number1326654245
StatusActive
Last updated in NPPESSep 16, 2020

Details

NPI
1326654245
Entity type
Individual (NPI-1)
Name
Kathrine G.D.A Levi
Sex
Female
Sole proprietor
No
Enumeration date
Sep 16, 2020
Certification date
Sep 14, 2020
Last updated
Sep 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
125J00000X Dental Therapist20-157-DHATAKYes

Practice location

700 Chief Eddie Hoffman Hwy
Bethel, AK 99559

Phone 907-543-6000

Mailing address

Po Box 528
Bethel, AK 99559-0528

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