Overview
No Referral Sources
No Referral Destinations
Practice Locations 1 Same Address Same Phone
No Medical Groups
No Affl. Hospitals
profile image
Primary Practice Address
4201 TUDOR CENTRE DR SUITE 320
ANCHORAGE, AK 99508-5904 US
PECOS Enrolled

John Etter

Dentist


John Etter

Overview

John Etter is a Dentist in the ANCHORAGE area. John Etter primary office location is at 4201 TUDOR CENTRE DR and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1205855251 and the information was updated approximately 17 years ago.

We have not detected any Exclusions tied directly to this NPI.

Accepts Medicare Assignment: Unknown

Is sole proprietor: NO

Participates in PECOS: YES (See any PECOS details below)

Contact Information

Primary Practice Location Information
4201 TUDOR CENTRE DR SUITE 320
ANCHORAGE, AK 99508-5904 US
Phone: (907)-317-6070
Fax:
Practice Mailing Information
PO BOX 196320
ANCHORAGE, AK 99508-5904 US
Phone: (907)-317-6070
Fax: (806)-794-1919
License NumberState
TX16496TX
Type/IssuerIdentifierState
MEDICAIDDD30831AK
UNITED CONCORDIA972671-
TaxonomyStatePrimary?
Dentist - Taxonomy Code 122300000X TXY

PECOS Details:

Participates in PECOS: YES
PECOS Individual Enrollment ID:
PECOS Individual PAC ID:
Eligible to order/refer Part B Clinical Laboratory and Imaging Yes
Eligible to order/refer Durable Medical Equipment (DME) Yes
Eligible to order/refer Home Health Agency (HHA) Yes
Eligible to order/refer Power Mobility Devices (PMD) -