Lydy, Charles Fredericks

Lydy, Charles Fredericks is an individual health care provider with primary practice located at 144 N Frost Dr , Saginaw MI 48638-7186. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Lydy, Charles Fredericks can be contacted via phone (989) 790-0700.

Contact Information

Primary practice address
144 N Frost Dr Saginaw MI 48638-7186
Phone: (989) 790-0700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12137 Michigan

Profile Details

NPI number 1457329518
LBN Legal business name Lydy, Charles Fredericks
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457329518 NPPES
Michigan MEDICAID 4053826

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