Provider Demographics
NPI:1790891497
Name:ALPINE DENTAL
Entity Type:Organization
Organization Name:ALPINE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAJCHROWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-272-0333
Mailing Address - Street 1:4120 LAUREL STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-272-0333
Mailing Address - Fax:907-272-0379
Practice Address - Street 1:4120 LAUREL STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-272-0333
Practice Address - Fax:907-272-0379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA7781223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty