Individual
ANGELA S FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
309 E MAIN ST, MOREHEAD, KY 40351-1659
(606) 784-6436
(606) 784-1665
Mailing address
309 E MAIN ST, MOREHEAD, KY 40351-1659
(606) 784-6436
(606) 784-1665
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8003
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6002953
—
KY
Enumeration date
10/13/2006
Last updated
07/22/2014
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