Provider Demographics
NPI:1245543941
Name:WALSH, ALISON SEIDL (DDS)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:SEIDL
Last Name:WALSH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 BONIFACE PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3144
Mailing Address - Country:US
Mailing Address - Phone:907-337-9448
Mailing Address - Fax:907-337-4123
Practice Address - Street 1:2601 BONIFACE PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3144
Practice Address - Country:US
Practice Address - Phone:907-337-9448
Practice Address - Fax:907-337-4123
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6548-015122300000X
AK1406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist