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Organization
KENDON A ROSS, DDS, MALIA FREDRICKSON, DDS, PA
Active
Organization
KENDON A ROSS, DDS, MALIA FREDRICKSON, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDON A ROSS DDS (OFFICER)
(864) 882-0620
Entity
Organization
Contact information
Practice address
10229 CLEMSON BLVD # A, SENECA, SC 29678-0817
(864) 882-0620
Mailing address
PO BOX 1897, SENECA, SC 29679-1897
(864) 882-0620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3260
SC
1223G0001X
General Practice Dentistry
3286
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9819
—
SC
Enumeration date
11/13/2006
Last updated
08/22/2020
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