DR. Brock Fred Tidstrom, DDS
NPI #1184065435 in Fairbanks, Alaska
Provider Information
- NPI Number
- 1184065435
- Entity Type
- Individual
- Name
- DR. Brock Fred Tidstrom, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Jul 16, 2013
- Last Updated
- Jul 16, 2013
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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