Individual
DR. CHARLES FREDERICKS LYDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
144 N FROST DR, SAGINAW, MI 48638-7186
(989) 790-0700
Mailing address
144 N FROST DR, SAGINAW, MI 48638-7186
(989) 790-0700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12137
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4053826
—
MI
Enumeration date
03/14/2006
Last updated
07/08/2007
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