James W Halliday Jr Dmd LLC
Clinic/Center, Dental in Kenai, AK. Organization (NPI-2).
NPI number1699080432
StatusActive
Last updated in NPPESAug 17, 2010
Details
- NPI
- 1699080432
- Entity type
- Organization (NPI-2)
- Legal business name
- James W Halliday Jr Dmd LLC
- Organization subpart
- No
- Enumeration date
- Aug 17, 2010
- Last updated
- Aug 17, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | D1148 | AK | Yes |
Other names
- Cook Inlet Dental (Doing Business As)
Practice location
908 Highland Ave Ste 2Kenai, AK 99611-8051
Phone 907-283-0454 · Fax 907-283-0456
Mailing address
908 Highland Ave Ste 1Kenai, AK 99611-8051
Phone 907-283-0454 · Fax 907-283-0456
Authorized official
James W Halliday
Dentist
9072830454
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