Provider Demographics
NPI:1083213128
Name:BITESIZE PEDIATRIC DENTISTRY, LLC
Entity Type:Organization
Organization Name:BITESIZE PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PEDIATRIC DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MIZE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-222-2483
Mailing Address - Street 1:9138 ARLON ST STE A2
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3876
Mailing Address - Country:US
Mailing Address - Phone:907-222-2483
Mailing Address - Fax:
Practice Address - Street 1:44539 STERLING HWY STE 208
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7960
Practice Address - Country:US
Practice Address - Phone:907-222-2483
Practice Address - Fax:907-929-2483
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BITESIZE PEDIATRIC DENTISTRY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty