Individual provider · NPI-1

Kelly Adrian

Dental Hygienist · Eagle River, AK

NPI number1396116182
StatusActive
Last updated in NPPESOct 19, 2015

Details

NPI
1396116182
Entity type
Individual (NPI-1)
Name
Kelly Adrian
Sex
Female
Sole proprietor
No
Enumeration date
Oct 19, 2015
Last updated
Oct 19, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
124Q00000X Dental HygienistDENH2193AKYes

Practice location

19436 Laura Lee Cir
Eagle River, AK 99577-8415

Phone 907-726-1171

Mailing address

19436 Laura Lee Cir
Eagle River, AK 99577-8415

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