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Search › Alaska › General Practice Dentistry

Brock Tidstrom, DDS

NPI 1184065435 · on the registry since 2013

Practice

Address
3112 Airport Way
Suite 1
Fairbanks, AK 99709
Phone
(907) 452-1250
Organisation at this address
Fairbanks Dental Center Llc
Daniel M. Bergeron, D.D.S., P.C.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
8

Registry record

Primary taxonomy
General Practice Dentistry
1223G0001X
Licence states on file
AK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2013-07-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska