Provider Demographics
NPI:1063863215
Name:ARCTIC FAMILY DENTAL
Entity Type:Organization
Organization Name:ARCTIC FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BEN
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-339-2331
Mailing Address - Street 1:3909 ARCTIC BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5770
Mailing Address - Country:US
Mailing Address - Phone:907-339-2331
Mailing Address - Fax:907-339-2332
Practice Address - Street 1:3909 ARCTIC BLVD
Practice Address - Street 2:STE 202
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5770
Practice Address - Country:US
Practice Address - Phone:907-339-2331
Practice Address - Fax:907-339-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK10261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty