Provider Demographics
NPI:1275792996
Name:HOSLEY, FREDERICK EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:EDWARD
Last Name:HOSLEY
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 1:2127 NE COACHMAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2631
Mailing Address - Country:US
Mailing Address - Phone:727-441-3719
Mailing Address - Fax:
Practice Address - Street 1:2127 NE COACHMAN RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2631
Practice Address - Country:US
Practice Address - Phone:727-441-3719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL70921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice