Individual
SANDRA FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
31245 HARPER AVE, SAINT CLAIR SHORES, MI 48082-1401
(586) 783-5505
Mailing address
1532 W 13 MILE RD, ROYAL OAK, MI 48073-4504
(586) 873-5505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021335
MI
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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