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MINNIE STREET CHILDREN’S DENTISTRY, PC 1770250292

Overview
Name: MINNIE STREET CHILDREN’S DENTISTRY, PC Specialty: Pediatric Dentist Type of Practice: Organization Provider/Org: Medical School: Graduation year from medical school: Affiliation:
Specialties
Practice Type: Dental Providers Classification: Dentist Specialization: Pediatric Dentistry. Definition of Specialty: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
License & NPI
License #(s): , , , , License State(s): , , , ,
Addresses
Practice Location: MINNIE STREET CHILDREN’S DENTISTRY, PC,114 MINNIE ST STE B,FAIRBANKS,AK,997013000,US Mailing Address: MINNIE STREET CHILDREN’S DENTISTRY, PC,114 MINNIE ST STE B,FAIRBANKS,AK,997013000,US
Contact #
Practice location phone #: 9073082200 Practice location fax #: Mailing address Phone #: 9073082200 Mailing Address fax #: Authorized official Name/Telephone #:DR., GREGORY, L, JOHNSON, DDS, MEMBER 9074798844
Misc
Date NPI was obtained: 08/24/2021 Last data data was updated: 08/24/2021 Insurances:
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