Individual
DR. FREDERICK WAYNE BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5400 N HIGH ST, COLUMBUS, OH 43214-1117
(614) 436-2817
(614) 436-3954
Mailing address
5400 N HIGH ST, COLUMBUS, OH 43214-1117
(614) 436-2817
(614) 436-3954
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-015399
OH
Other
Enumeration date
06/05/2006
Last updated
07/08/2007
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