Individual
MELISSA KAYLA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
602 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 240-7411
Mailing address
24404 HIGHFLY CIR APT 1, FORT RILEY, KS 66442-4706
(301) 653-6443
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13623
KS
124Q00000X
Dental Hygienist
26826
TX
Other
Enumeration date
06/15/2024
Last updated
07/30/2024
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