BROCK FRED TIDSTROM

FAIRBANKS, AK
NPI1184065435
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: AK  1505)
Enumeration Date2013-07-16
Last Update Date2013-07-16
Business Address
Dr. BROCK FRED TIDSTROM DDS
3112 AIRPORT WAY SUITE 1
FAIRBANKS, AK 99709-4754
Phone number: 907-452-1250
Mailing Address
Dr. BROCK FRED TIDSTROM DDS
3112 AIRPORT WAY SUITE 1
FAIRBANKS, AK 99709-4754
Phone number: 907-452-1250