| Frederick Dental Group | |
|
44 S Main St Wilkes Barre PA 18701-1705 | |
| (570) 829-2691 | |
| Not Available |
| Full Name | Frederick Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 44 S Main St, Wilkes Barre, Pennsylvania |
| Authorized Official Name and Position | Donald Frederick (SOLE PROPRIETOR) |
| Authorized Official Contact | 5708292691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick Dental Group Rr 3 Box 155 Harveys Lake PA 18618-9403 Ph: () - | Frederick Dental Group 44 S Main St Wilkes Barre PA 18701-1705 Ph: (570) 829-2691 |
| NPI Number | 1871628370 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871628370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19534-L (Pennsylvania) | Primary |
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