| Organization Name: | KODIAK AREA NATIVE ASSOCIATION |
| NPI Number: | 1205883907 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREW TEUBER (PRESIDENT/CEO) |
| Mailing Address: | 3449 E Rezanof Dr Kodiak |
| State: | AK US |
| Postal Code: | 996156952 |
| Phone Number: | 9074869800 |
| Fax Number: | 9074869897 |
| NPI Enumeration Date: | 05/28/2006 |
| NPI Last Update Date: | 03/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 233103 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |