Individual
DR. JESSICA L WOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MSD, CO
Contact information
Practice address
1919 LATHROP ST, SUITE 102, FAIRBANKS, AK 99701-5937
(907) 452-2939
(907) 451-7330
Mailing address
1919 LATHROP ST, SUITE 102, FAIRBANKS, AK 99701-5937
(907) 452-2939
(907) 451-7330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1249
AK
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
162
AK
Other
Enumeration date
08/04/2009
Last updated
10/29/2009
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