Individual
FREDERICK ANTHONY FENDERSON
Active
Individual
FREDERICK ANTHONY FENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
42820
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-4566
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
589393
ACCESS
AZ
Enumeration date
08/19/2006
Last updated
07/08/2007
Update your record
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