Provider Demographics
NPI:1336388693
Name:DEKAY, ELDON LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELDON
Middle Name:LEE
Last Name:DEKAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16635 CENTERFIELD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7719
Mailing Address - Country:US
Mailing Address - Phone:907-694-3555
Mailing Address - Fax:907-694-3320
Practice Address - Street 1:16635 CENTERFIELD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7719
Practice Address - Country:US
Practice Address - Phone:907-694-3555
Practice Address - Fax:907-694-3320
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics