Frederick Anthony Fenderson, DDS
Dentist, Orthodontics and Dentofacial Orthopedics in Prescott, AZ. Individual provider (NPI-1).
NPI number1619081064
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1619081064
- Entity type
- Individual (NPI-1)
- Name
- Frederick Anthony Fenderson
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 19, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | D-4566 | AZ | Yes |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 42820 | CA |
Practice location
3150 Clearwater DrPrescott, AZ 86305-7131
Phone 928-445-7051 · Fax 928-778-1731
Mailing address
3150 Clearwater DrPrescott, AZ 86305-7131
Phone 928-445-7051 · Fax 928-778-1731
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