Jonathon Karl Frederiksen, RDH

NPI #1912355629 in Pecos, New Mexico

Provider Information

NPI Number: 1912355629
Entity Type: Individual
Name: Jonathon Karl Frederiksen, RDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH
Enumeration Date: Jun 3, 2016
Last Updated: Jun 3, 2016

Practice Location

Address: 199 HWY 50
City: Pecos
State: New Mexico
ZIP Code: 87552
Phone: (505) 757-6666

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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