Provider Demographics
NPI:1023102076
Name:KUNZ, FREDERICK WILLIAM IV (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:KUNZ
Suffix:IV
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 1:8940 GREENBELT DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-5550
Mailing Address - Country:US
Mailing Address - Phone:907-245-0810
Mailing Address - Fax:907-245-0810
Practice Address - Street 1:8940 GREENBELT DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5550
Practice Address - Country:US
Practice Address - Phone:907-245-0810
Practice Address - Fax:907-245-0810
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDD40832Medicaid
AKDD40833Medicaid
AKDD408FQMedicaid