Fredrickson, Malia
Fredrickson, Malia is an individual health care provider with primary practice located at 10229A Clemson Blvd , Seneca SC 29678-0817. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Fredrickson, Malia can be contacted via phone (864) 882-0620.Contact Information
Primary practice address
10229A Clemson Blvd
Seneca SC 29678-0817
Phone: (864) 882-0620
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3260 | South Carolina |
Profile Details
| NPI number | 1275578791 |
|---|---|
| LBN Legal business name | Fredrickson, Malia |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275578791 | NPPES |
| South Carolina | MEDICAID | ZX3260 | |
| South Carolina | MEDICAID | ZA9819 |
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