Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 1053 | AK |
NPI | 1003147273 |
---|---|
Provider Name | Dr. David Lynn Maisey |
First Address | Anchorage, AK 99503-4001 |
Second Address | Anchorage, AK 99503-4001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2010 |
Last Update Date | 27/01/2010 |