Provider Demographics
NPI:1851857098
Name:ALL ALASKA ORAL & CRANIOFACIAL SURGERY, P.C.
Entity Type:Organization
Organization Name:ALL ALASKA ORAL & CRANIOFACIAL SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DASHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:907-764-4760
Mailing Address - Street 1:4200 LAKE OTIS PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5226
Mailing Address - Country:US
Mailing Address - Phone:907-764-4760
Mailing Address - Fax:907-764-4762
Practice Address - Street 1:4200 LAKE OTIS PKWY STE 202
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5226
Practice Address - Country:US
Practice Address - Phone:907-764-4760
Practice Address - Fax:907-764-4762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty