Provider Demographics
NPI:1992126486
Name:MATTHEW PAIGE DDS & JASON M BRESSLER DDS-ANCHORAGE, LLC
Entity type:Organization
Organization Name:MATTHEW PAIGE DDS & JASON M BRESSLER DDS-ANCHORAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-370-6653
Mailing Address - Street 1:4001 LAKE OTIS PKWY
Mailing Address - Street 2:#200
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5200
Mailing Address - Country:US
Mailing Address - Phone:253-370-6653
Mailing Address - Fax:
Practice Address - Street 1:4001 LAKE OTIS PKWY
Practice Address - Street 2:#200
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5200
Practice Address - Country:US
Practice Address - Phone:253-370-6653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK15301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty