Provider Demographics
NPI:1295877991
Name:OLDEN, FREDERICK E (DDS,MSD,INC)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:E
Last Name:OLDEN
Suffix:
Gender:M
Credentials:DDS,MSD,INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 WESTCHESTER DR STE 230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6116
Mailing Address - Country:US
Mailing Address - Phone:214-691-8161
Mailing Address - Fax:
Practice Address - Street 1:8215 WESTCHESTER DR STE 230
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6116
Practice Address - Country:US
Practice Address - Phone:214-691-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics