Jonathan P Woller D.m.d. PC

NPI #1407159775 in Fairbanks, Alaska

Provider Information

NPI Number: 1407159775
Entity Type: Organization
Organization Name: Jonathan P Woller D.m.d. PC
Primary Specialty: Dentist
Enumeration Date: Dec 8, 2010
Last Updated: Dec 8, 2010

Practice Location

Address: 3535 COLLEGE RD
Address 2: SUITE #205
City: Fairbanks
State: Alaska
ZIP Code: 99709-3722
Phone: (907) 479-6747

Authorized Official

Name: DR. JONATHAN PATRICK WOLLER, D.M .D.
Title: PRESIDENT
Phone: (907) 479-6747

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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