Paul A. Fredrikson, D.d.s., P.c. | |
3011 25th St S Suite 1 Fargo ND 58103-6162 | |
(701) 280-0088 | |
(701) 293-5602 |
Full Name | Paul A. Fredrikson, D.d.s., P.c. |
---|---|
Speciality | Dentist - General Practice |
Location | 3011 25th St S, Fargo, North Dakota |
Authorized Official Name and Position | Paul A Fredrikson (PRESIDENT) |
Authorized Official Contact | 7012800088 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Paul A. Fredrikson, D.d.s., P.c. 3011 25th St S Suite 1 Fargo ND 58103-6162 Ph: (701) 280-0088 | Paul A. Fredrikson, D.d.s., P.c. 3011 25th St S Suite 1 Fargo ND 58103-6162 Ph: (701) 280-0088 |
NPI Number | 1003237512 |
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Provider Enumeration Date | 12/31/2013 |
Last Update Date | 01/06/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003237512 | NPI | - | NPPES |
40631 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 1504 (North Dakota) | Primary |
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