Individual
DR. FONDA R PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7357 W ADDISON ST, CHICAGO, IL 60634-3429
(773) 889-6100
(773) 889-8737
Mailing address
7357 W ADDISON ST, CHICAGO, IL 60634-3429
(773) 889-6100
(773) 889-8737
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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