Individual
GORDON U FREDEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,P.A.
Contact information
Practice address
401 EAST DUAL BLVD, ISANTI, MN 55040
(763) 444-5541
(763) 444-5542
Mailing address
PO BOX 310, ISANTI, MN 55040-0310
(763) 444-5541
(763) 444-5542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8649
MN
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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