Organization
LIVINGSTON DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE A FREDERICKSON DDS (OWNER)
(406) 222-6061
Entity
Organization
Contact information
Practice address
422 S MAIN ST, LIVINGSTON, MT 59047-3456
(406) 222-6061
(406) 222-6062
Mailing address
422 S MAIN ST, LIVINGSTON, MT 59047-3456
(406) 222-6061
(406) 222-6062
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1299
MT
1223G0001X
General Practice Dentistry
1835
MT
1223G0001X
General Practice Dentistry
Primary
2104
MT
1223G0001X
General Practice Dentistry
2318
MT
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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