Provider Demographics
NPI:1477092682
Name:MONTPETIT, FREDERIQUE (DMD)
Entity Type:Individual
Prefix:MRS
First Name:FREDERIQUE
Middle Name:
Last Name:MONTPETIT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 KILAUEA AVE.
Mailing Address - Street 2:HILO FAMILY DENTAL CENTER
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-333-3610
Mailing Address - Fax:808-930-0438
Practice Address - Street 1:1257 KILAUEA AVE SUITE 100
Practice Address - Street 2:HILO FAMILY DENTAL CENTER
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-333-3610
Practice Address - Fax:808-930-0438
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program