Individual
JONATHAN P WOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3535 COLLEGE RD, SUITE #205, FAIRBANKS, AK 99709-3722
(907) 479-6747
(907) 479-5786
Mailing address
3535 COLLEGE RD, SUITE #205, FAIRBANKS, AK 99709-3722
(907) 479-6747
(907) 479-5786
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1155
AK
122300000X
Dentist
Primary
D11967
MN
Other
Enumeration date
12/26/2006
Last updated
12/09/2010
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