# ROBERT HERBERT FREDRICKSON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ROBERT H FREDRICKSON DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386020170
- **Authorized official:** ROBERT H FREDRICKSON DDS (OWNER)
- **Authorized official phone:** (570) 326-6170

## Contact information

- **Practice address:** 1124 MARKET ST, WILLIAMSPORT, PA 17701-2124
- **Practice address phone:** (570) 326-6170
- **Mailing address:** 1124 MARKET ST, WILLIAMSPORT, PA 17701-2124
- **Mailing address phone:** (570) 326-6170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS017415L | PA | Yes |

## Other

- **Enumeration date:** 08/04/2015
- **Last updated:** 11/02/2015