Provider Demographics
NPI:1285000505
Name:CHRISTINE MOLESKI, DMD, P.C.
Entity Type:Organization
Organization Name:CHRISTINE MOLESKI, DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MOLESKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-789-0131
Mailing Address - Street 1:9191 LEE SMITH DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8017
Mailing Address - Country:US
Mailing Address - Phone:907-789-0131
Mailing Address - Fax:907-789-7110
Practice Address - Street 1:9191 LEE SMITH DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8017
Practice Address - Country:US
Practice Address - Phone:907-789-0131
Practice Address - Fax:907-789-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty