Provider Demographics
NPI:1639785504
Name:VDCAK
Entity Type:Organization
Organization Name:VDCAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-376-3884
Mailing Address - Street 1:935 E WESTPOINT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7181
Mailing Address - Country:US
Mailing Address - Phone:907-354-0757
Mailing Address - Fax:
Practice Address - Street 1:935 E WESTPOINT DR STE 201
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7181
Practice Address - Country:US
Practice Address - Phone:907-354-0757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental