OrganizationActive
Fairbanks Orthodontic Group a Prof Corp
NPI 1013084680 · Orthodontics and Dentofacial Orthopedics Dentistry · Fairbanks, AK
Provider details
- NPI number
- 1013084680
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Authorized official
- Walt Babula, President Orthodontist
- License
- AK330 (AK)
Practice location
1919 Lathrop St
Suite 102
Fairbanks, AK 99701
Phone: (907) 452-2939
Fax: (907) 451-7330
Mailing address
1919 Lathrop St
Fairbanks, AK 99701
Registry dates
- Enumerated
- 2006-11-29
- Last updated
- 2013-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.