DR. Glenn M. Frederick

NPI #1174676589 in Canterbury, Connecticut

Provider Information

NPI Number: 1174676589
Entity Type: Individual
Name: DR. Glenn M. Frederick
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 19, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 37 S CANTERBURY RD
City: Canterbury
State: Connecticut
ZIP Code: 06331-1520
Phone: (860) 546-9434

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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