Provider Demographics
NPI:1003836776
Name:GUNTER, FREDERICK MADISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:MADISON
Last Name:GUNTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7465 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-4209
Mailing Address - Country:US
Mailing Address - Phone:843-553-7300
Mailing Address - Fax:843-797-7631
Practice Address - Street 1:7465 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-4209
Practice Address - Country:US
Practice Address - Phone:843-553-7300
Practice Address - Fax:843-797-7631
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC01561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics