Individual
DR. FREDERIC CLYDE RATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9042 COLUMBIA AVE, STE A, MUNSTER, IN 46321-2905
(219) 836-5656
(219) 836-0455
Mailing address
9042 COLUMBIA AVE, STE A, MUNSTER, IN 46321-2905
(219) 836-5656
(219) 836-0455
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008608A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
609186400
OWCP
—
Enumeration date
08/09/2006
Last updated
03/04/2016
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