Provider Demographics
NPI:1013222389
Name:BYE, FRED L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:L
Last Name:BYE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13424 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2658
Mailing Address - Country:US
Mailing Address - Phone:301-739-6868
Mailing Address - Fax:301-790-4990
Practice Address - Street 1:13424 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2658
Practice Address - Country:US
Practice Address - Phone:301-739-6868
Practice Address - Fax:301-790-4990
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0296071223P0300X
MD111281223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics