| NPI | 1386020170 |
|---|---|
| Other Name | ROBERT H FREDRICKSON DDS |
| Entity Type | Organization |
| Authorized Contact | ROBERT H FREDRICKSON Owner 570-326-6170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS017415L) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-11-02 |