Individual
DR. FREDERICK BRYAN TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2002 EASTWOOD RD, STE 105, WILMINGTON, NC 28403
(910) 256-9040
(910) 256-2463
Mailing address
2002 EASTWOOD RD, STE 105, WILMINGTON, NC 28403
(910) 256-9040
(910) 256-2463
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6728
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
646240
UNITED CONCORDIA
—
01
—
9016H
BCBS
NC
05
—
97551
—
NC
Enumeration date
09/12/2006
Last updated
07/08/2007
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