Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK C. FREDRICKSON, D.D.S.
ActiveDR. JACK C. FREDRICKSON, D.D.S. is a General Dentistry healthcare provider located in LAKE HAVASU CITY, Arizona. NPI 1427017979 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · LAKE HAVASU CITY, AZ
Registration Details
- NPI Number
- 1427017979
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 22, 2006 (20.361443182779 yrs)
- Last Updated
- Jul 8, 2007
- License
-
2079 (AZ)
Practice Information
- Address
-
1930 MESQUITE AVESTE. 8LAKE HAVASU CITY, AZ, 864035674Browse AZ providers · Browse ZIP 86403
- Phone
- 9288554347
- Fax
- 9288556894
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in LAKE HAVASU CITY, AZ
| Name | Credential | NPI |
|---|---|---|
| DR. EDOUARD SORKIN | DDS | 1205833639 |
| DR. DEE DENNIS MOSHOS SR. | D.D.S. | 1669559357 |
| DR. EDWARD B AHN | DDS | 1700956562 |
| DR. JULIA E. CARLSON | D.D.S. | 1497818652 |
| DR. DEBORAH ANN KINZER | D.D.S. | 1528106093 |
| DR. DON F CHRISTIE | DMD | 1508983867 |
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.