| Fredrick W Wicknick Dmd Inc Ps | |
|
3136 Squalicum Pkwy Suite #b Bellingham WA 98225-1954 | |
| (360) 671-4859 | |
| (360) 671-3010 |
| Full Name | Fredrick W Wicknick Dmd Inc Ps |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3136 Squalicum Pkwy, Bellingham, Washington |
| Authorized Official Name and Position | Fredrick W Wicknick (PRESIDENT) |
| Authorized Official Contact | 3606714859 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredrick W Wicknick Dmd Inc Ps 3136 Squalicum Pkwy Suite #b Bellingham WA 98225-1954 Ph: (360) 671-4859 | Fredrick W Wicknick Dmd Inc Ps 3136 Squalicum Pkwy Suite #b Bellingham WA 98225-1954 Ph: (360) 671-4859 |
| NPI Number | 1659592103 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 11/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659592103 | NPI | - | NPPES |
| 08367 | Other | WA | WDS |
| 581903 | Other | WA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DE00006347 (Washington) | Primary |
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