Organization
JONATHAN P WOLLER D.M.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN PATRICK WOLLER D.M .D. (PRESIDENT)
(907) 479-6747
Entity
Organization
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
Primary
1155
AK
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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