Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DEND768 | AK |
Y | 1223P0221X | Pediatric Dentist | DEND768 | AK |
NPI | 1023037074 |
---|---|
Provider Name | James Singleton |
First Address | Anchorage, AK 99508-5919 |
Second Address | Anchorage, AK 99508-5904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 03/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
834633 | UNITED CONCORDIA (01) | |
DD0768 | (05) | AK |