Provider Demographics
NPI:1750470290
Name:EICHMILLER, FREDERICK CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:CHARLES
Last Name:EICHMILLER
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 1:3972 N HAYMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MOSINEE
Mailing Address - State:WI
Mailing Address - Zip Code:54455-9113
Mailing Address - Country:US
Mailing Address - Phone:715-295-0426
Mailing Address - Fax:715-344-9058
Practice Address - Street 1:3972 N HAYMEADOW DR
Practice Address - Street 2:
Practice Address - City:MOSINEE
Practice Address - State:WI
Practice Address - Zip Code:54455-9113
Practice Address - Country:US
Practice Address - Phone:715-295-0426
Practice Address - Fax:715-344-9058
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND91791223G0001X
MD95501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice