Organization
HARRISBURG ORTHODONTICS ASSOC LLC
Active
Organization
HARRISBURG ORTHODONTICS ASSOC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HERBERT FREDRICKSON DDS,MAGD (OWNER)
(570) 326-1481
Entity
Organization
Contact information
Practice address
3731 WALNUT ST, SUITE 1, HARRISBURG, PA 17109-2555
(717) 545-3187
(717) 920-9402
Mailing address
3731 WALNUT ST, SUITE 1, HARRISBURG, PA 17109-2555
(717) 545-3187
(717) 920-9402
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DSD17415L
PA
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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