Frederick Anthony Fenderson DDS

NPI 1619081064 - Dentist - 1223X0400X

NPI Details
NPI 1619081064
Gender Male
Enumeration Date 08/19/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3150 CLEARWATER DR
PRESCOTT AZ, 86305-7131, US
Phone (928) 445-7051
Fax (928) 778-1731
Business Location
3150 CLEARWATER DR
PRESCOTT AZ, 86305-7131, US
Phone (928) 445-7051
Fax (928) 778-1731
Toxanomy
Taxonomy Code 1223X0400X
License State California
License Number 42820
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According to our database, Frederick Anthony Fenderson DDS NPI is 1619081064, taxonomy code is 1223X0400X and license number is 42820, license state is located at California. Frederick Anthony Fenderson DDS physically located at 3150 Clearwater Dr, Prescott AZ, 86305-7131. NPI Number Frederick Anthony Fenderson DDS has the Individual type.

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1619081064 NPI number is provided on an as is basis without warranty of any kind. 1619081064 is maintained by the National Plan & Provider Enumeration System. The contents of Frederick Anthony Fenderson DDS are for informational purposes only.