Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 1276 | AK |
NPI | 1609031285 |
---|---|
Provider Name | Dr. Andrew James Wappett |
First Address | Fairbanks, AK 99701-4803 |
Second Address | Fairbanks, AK 99701-4803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2008 |
Last Update Date | 23/07/2008 |