JACK C. FREDRICKSON

LAKE HAVASU CITY, AZ
NPI1427017979
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: AZ  2079)
Enumeration Date2006-03-22
Last Update Date2007-07-08
Business Address
DR. JACK C. FREDRICKSON D.D.S.
1930 MESQUITE AVE STE. 8
LAKE HAVASU CITY, AZ 86403-5674
Phone number: 928-855-4347
Mailing Address
DR. JACK C. FREDRICKSON D.D.S.
2061 BRYCE CIR
LAKE HAVASU CITY, AZ 86406-8352
Phone number: 928-855-6505
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