Basic Information
| Provider Information | |||||||||
| NPI: | 1841273737 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AITA-HOLMES | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1060 GAFFNEY #7500 | ||||||||
| Address2: | |||||||||
| City: | FORT WAINWRIGHT | ||||||||
| State: | AK | ||||||||
| PostalCode: | 997037500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073534114 | ||||||||
| FaxNumber: | 9073534852 | ||||||||
| Practice Location | |||||||||
| Address1: | 1060 GAFFNEY #7500 | ||||||||
| Address2: | |||||||||
| City: | FORT WAINWRIGHT | ||||||||
| State: | AK | ||||||||
| PostalCode: | 997037500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073534114 | ||||||||
| FaxNumber: | 9073534852 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2005 | ||||||||
| LastUpdateDate: | 09/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0700X | 052713 | NY | Y | Dental Providers | Dentist | Prosthodontics |
No ID Information.