Provider Demographics
NPI:1851733406
Name:DEBORAH E. WRIGLEY, DDS, LLC
Entity Type:Organization
Organization Name:DEBORAH E. WRIGLEY, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:EDITH
Authorized Official - Last Name:WRIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-333-9591
Mailing Address - Street 1:2601 BONIFACE PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3144
Mailing Address - Country:US
Mailing Address - Phone:907-333-9591
Mailing Address - Fax:
Practice Address - Street 1:2601 BONIFACE PKWY STE 3
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3144
Practice Address - Country:US
Practice Address - Phone:907-333-9591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK001628449OtherMILITARY
AKDD91623Medicaid