Duclos, Jack B
Duclos, Jack B is an sole proprietor health care provider with primary practice located at 1836 W Northern Lights Blvd , Anchorage AK 99517-3342. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Duclos, Jack B can be contacted via phone (907) 272-3200.Contact Information
Primary practice address
1836 W Northern Lights Blvd
Anchorage AK 99517-3342
Phone: (907) 272-3200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 871 | Alaska |
Profile Details
| NPI number | 1518187210 |
|---|---|
| LBN Legal business name | Duclos, Jack B |
| Credentials | D.D.S, M.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 26th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518187210 | NPPES |
| Alaska | MEDICAID | DD0871 |
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