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1124172259
WAYNE ANTHONY FREDERICKSON
LIVINGSTON, MT
NPI
1124172259
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MT 2104)
Enumeration Date
2007-01-23
Last Update Date
2007-07-08
Business Address
Dr. WAYNE ANTHONY FREDERICKSON D.D.S.
422 S MAIN ST
LIVINGSTON, MT 59047-3456
Phone number: 406-222-6061
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Mailing Address
Dr. WAYNE ANTHONY FREDERICKSON D.D.S.
422 S MAIN ST
LIVINGSTON, MT 59047-3456
Phone number: 406-222-6061
Copy
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