Individual
DR. TANNER DOUGLAS ZYLSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3487 AIRPORT WAY, FAIRBANKS, AK 99709-4761
(907) 479-7771
Mailing address
109 CHIEF CHARLIE DR, FAIRBANKS, AK 99709-4861
(909) 967-8052
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
135404
AK
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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