Provider Demographics
NPI:1326559220
Name:ALEUTIAN FAMILY DENTISTRY, INC.
Entity Type:Organization
Organization Name:ALEUTIAN FAMILY DENTISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:MACARTHUR
Authorized Official - Suffix:IV
Authorized Official - Credentials:DMD, MPH
Authorized Official - Phone:907-519-9757
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:UNALASKA
Mailing Address - State:AK
Mailing Address - Zip Code:99685-1010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:159 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:UNALASKA
Practice Address - State:AL
Practice Address - Zip Code:99685
Practice Address - Country:US
Practice Address - Phone:907-581-3122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK104564261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental