Individual
DR. DARYL FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2641 SHIRLEY DR, JACKSON, MI 49201-8633
(517) 787-5367
(517) 787-4219
Mailing address
2641 SHIRLEY DR, JACKSON, MI 49201-8633
(517) 787-5367
(517) 787-4219
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10125
MI
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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