Deeter, William Randy

Deeter, William Randy is an individual health care provider with primary practice located at 111 W 16Th Ave Suite 203, Anchorage AK 99501-6206. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Deeter, William Randy can be contacted via phone (907) 561-1430.

Contact Information

Primary practice address
111 W 16Th Ave Suite 203 Anchorage AK 99501-6206
Phone: (907) 561-1430
Fax: (907) 561-2697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 654 Alaska

Profile Details

NPI number 1457365827
LBN Legal business name Deeter, William Randy
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Apr 10th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457365827 NPPES
Alaska Other 480642 TRI-CARE ID
Alaska MEDICAID DD0654 TRI-CARE ID

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