| Nicholas A. Fredericka D.m.d. Inc. | |
|
822 Robbins Ave Niles OH 44446-2432 | |
| (330) 652-6500 | |
| (330) 652-6550 |
| Full Name | Nicholas A. Fredericka D.m.d. Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 822 Robbins Ave, Niles, Ohio |
| Authorized Official Name and Position | Nicholas Anthony Fredericka (PRESIDENT) |
| Authorized Official Contact | 3306526500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas A. Fredericka D.m.d. Inc. 822 Robbins Ave Niles OH 44446-2432 Ph: (330) 652-6500 | Nicholas A. Fredericka D.m.d. Inc. 822 Robbins Ave Niles OH 44446-2432 Ph: (330) 652-6500 |
| NPI Number | 1013136746 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013136746 | NPI | - | NPPES |
| 196764 | Other | OH | UNITED CONCORDIA INS. ID# |
| 0493729 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30016140 (Ohio) | Primary |
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