| Paul A. Fredrikson, D.D.S., P.C. | |
|
3011 25th St S Suite 1 Fargo ND 58103-6162 | |
| (701) 280-0088 | |
| (701) 293-5602 |
| Full Name | Paul A. Fredrikson, D.D.S., P.C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3011 25th St S, Fargo, North Dakota |
| Authorized Official Name and Position | Paul a Fredrikson (PRESIDENT) |
| Authorized Official Contact | 7012800088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul A. Fredrikson, D.D.S., P.C. 3011 25th St S Suite 1 Fargo ND 58103-6162 Ph: (701) 280-0088 | Paul A. Fredrikson, D.D.S., P.C. 3011 25th St S Suite 1 Fargo ND 58103-6162 Ph: (701) 280-0088 |
| NPI Number | 1003237512 |
|---|---|
| Provider Enumeration Date | 12/31/2013 |
| Last Update Date | 01/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003237512 | NPI | - | NPPES |
| 40631 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1504 (North Dakota) | Primary |
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