Organization
FRIDERES DENTAL LLC
Active
Parent organization
FRIDERES DENTAL LLC
Other names
Sisters Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRIDERES DENTAL LLC
Authorized official
TREVOR MATHIAS BAUER FRIDERES D.M.D. (MEMBER DENTIST)
(541) 549-2011
Entity
Organization
Contact information
Practice address
491 E MAIN AVE, SISTERS, OR 97759-0197
(541) 549-2011
(541) 549-4787
Mailing address
PO BOX 10, SISTERS, OR 97759-0010
(541) 549-2011
(541) 549-4787
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/27/2019
Last updated
01/27/2019
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