Jon D Tanner, Dds, PC

NPI #1851634265 in Fairbanks, Alaska

Provider Information

NPI Number: 1851634265
Entity Type: Organization
Organization Name: Jon D Tanner, Dds, PC
Primary Specialty: Dentist
Enumeration Date: Apr 3, 2013
Last Updated: Apr 3, 2013

Practice Location

Address: 1305 21ST AVE
Address 2: SUITE 102
City: Fairbanks
State: Alaska
ZIP Code: 99701-6084
Phone: (907) 456-5665

Authorized Official

Name: JON D TANNER, DDS
Title: PRESIDENT
Phone: (907) 456-5665

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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