Provider Demographics
NPI:1689889040
Name:MERKLE, FREDERICK BROEKER (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:BROEKER
Last Name:MERKLE
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 1:568 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1055
Mailing Address - Country:US
Mailing Address - Phone:908-665-9595
Mailing Address - Fax:908-665-9575
Practice Address - Street 1:568 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1055
Practice Address - Country:US
Practice Address - Phone:908-665-9595
Practice Address - Fax:908-665-9575
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI202111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice