| Kendon A Ross, Dds, Malia Fredrickson, Dds, Pa | |
|
10229 Clemson Blvd # A Seneca SC 29678-0817 | |
| (864) 882-0620 | |
| Not Available |
| Full Name | Kendon A Ross, Dds, Malia Fredrickson, Dds, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10229 Clemson Blvd # A, Seneca, South Carolina |
| Authorized Official Name and Position | Kendon A Ross (OFFICER) |
| Authorized Official Contact | 8648820620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kendon A Ross, Dds, Malia Fredrickson, Dds, Pa Po Box 1897 Seneca SC 29679-1897 Ph: (864) 882-0620 | Kendon A Ross, Dds, Malia Fredrickson, Dds, Pa 10229 Clemson Blvd # A Seneca SC 29678-0817 Ph: (864) 882-0620 |
| NPI Number | 1558432146 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558432146 | NPI | - | NPPES |
| ZA9819 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3286 (South Carolina) | Secondary |
| 1223G0001X | Dentist - General Practice | 3260 (South Carolina) | Primary |
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