Polis, Susan Jeanne
Polis, Susan Jeanne is an individual health care provider with primary practice located at 549 Grubstake Ave Suite A, Homer AK 99603-7640. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Polis, Susan Jeanne can be contacted via phone (907) 235-1286.Contact Information
Primary practice address
549 Grubstake Ave Suite A
Homer AK 99603-7640
Phone: (907) 235-1286
Fax: (907) 235-1263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 935 | Alaska |
Profile Details
| NPI number | 1023144540 |
|---|---|
| LBN Legal business name | Polis, Susan Jeanne |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1023144540 | NPPES |
| Alaska | MEDICAID | D951 |
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