Fredrickson, Jack C.

Fredrickson, Jack C. is an individual health care provider with primary practice located at 1930 Mesquite Ave Ste. 8, Lake Havasu City AZ 86403-5674. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Fredrickson, Jack C. can be contacted via phone (928) 855-4347.

Contact Information

Primary practice address
1930 Mesquite Ave Ste. 8 Lake Havasu City AZ 86403-5674
Phone: (928) 855-4347
Fax: (928) 855-6894
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2079 Arizona

Profile Details

NPI number 1427017979
LBN Legal business name Fredrickson, Jack C.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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