Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GLENN M. FREDERICK
Active Sole ProprietorDR. GLENN M. FREDERICK is a General Dentistry healthcare provider located in CANTERBURY, Connecticut. NPI 1174676589 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · CANTERBURY, CT
Registration Details
- NPI Number
- 1174676589
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 19, 2007 (19.547203555446 yrs)
- Last Updated
- Jul 8, 2007
- License
-
5093 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
37 S CANTERBURY RDCANTERBURY, CT, 063311520Browse CT providers · Browse ZIP 06331
- Phone
- 8605469434
- Primary Specialty
-
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.