Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 8743 | NC |
NPI | 1689659328 |
---|---|
Provider Name | Dr. Rory Barton Frederick |
First Address | Robbinsville, NC 28771-2326 |
Second Address | Robbinsville, NC 28771-9054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 14/05/2013 |