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Individual
JONATHAN FREDERICK
Active
Individual
JONATHAN FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
AL5271
AL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
AL28212
AL
Other
Enumeration date
01/04/2007
Last updated
11/15/2011
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