Provider Demographics
NPI:1104948884
Name:ALLGAIR, EDWIN HENRY JR (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:HENRY
Last Name:ALLGAIR
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1051
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:AK
Mailing Address - Zip Code:99672-1051
Mailing Address - Country:US
Mailing Address - Phone:206-419-0787
Mailing Address - Fax:
Practice Address - Street 1:660 THIRD AVE STE C
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:AK
Practice Address - Zip Code:99559-0169
Practice Address - Country:US
Practice Address - Phone:907-545-3996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKD997122300000X
WADE00010502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1003258Medicaid