Provider Demographics
NPI:1659402279
Name:DREHER, FREDERICK D (DDS)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:D
Last Name:DREHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:FREDERICK
Other - Middle Name:
Other - Last Name:DREHER, D.D.S., P.C.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:410 ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2684
Mailing Address - Country:US
Mailing Address - Phone:518-885-6185
Mailing Address - Fax:
Practice Address - Street 1:410 ROWLAND ST
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-2684
Practice Address - Country:US
Practice Address - Phone:518-885-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0432321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice