Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BROCK FRED TIDSTROM, DDS
ActiveDR. BROCK FRED TIDSTROM, DDS is a General Dentistry healthcare provider located in FAIRBANKS, Alaska. NPI 1184065435 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · FAIRBANKS, AK
Registration Details
- NPI Number
- 1184065435
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 16, 2013 (13.071567731356 yrs)
- Last Updated
- Jul 16, 2013
- License
-
1505 (AK)
Practice Information
- Address
-
3112 AIRPORT WAYSUITE 1FAIRBANKS, AK, 997094754Browse AK providers · Browse ZIP 99709
- Phone
- 9074521250
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in FAIRBANKS, AK
| Name | Credential | NPI |
|---|---|---|
| DR. GEORGE GREGORY BIRD | D.D.S. | 1710950225 |
| DR. ARTHUR STANLEY HANSEN | D.D.S. | 1386671170 |
| DR. MICHAEL RICHARD KWASINSKI | DDS | 1255362901 |
| JAMES A CERNEY | DDS | 1962426700 |
| DR. PATRICIA L. BERGDAHL | D.M.D. | 1225043607 |
| JOHN P BAST | D.D.S | 1124037478 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.