DR. JACK FREDRICKSON, D.D.S.

Dentist - General Practice

Active Individual
NPI: 1427017979

Practice Address

1930 MESQUITE AVE
STE. 8
Lake Havasu City, AZ 86403

Phone: (928) 855-4347

Specialties

Specialty Code Primary License
Dentist - General Practice 1223G0001X Yes 2079 (AZ)

Frequently Asked Questions

NPI 1427017979 is the National Provider Identifier for DR. JACK FREDRICKSON, D.D.S., a Dentist - General Practice provider located in Lake Havasu City, AZ. This NPI was enumerated on March 22, 2006.
DR. JACK FREDRICKSON, D.D.S. practices at 1930 MESQUITE AVE, STE. 8, Lake Havasu City, AZ 86403.

Quick Facts

NPI
1427017979
Type
Individual
Enumerated
Mar 22, 2006
Last Updated
Jul 8, 2007

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