MEDICARE: DR. FREDERICK W. ARNOLD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	09820	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306923065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK W. ARNOLD DDS

Provider Business Mailing Address
First Line	:	541 S GARFIELD AVE
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3423
Country	:	US
Telephone Number	:	231-941-4090
Fax Number	:	231-941-4048

Provider Business Practice Location Address
First Line	:	541 S GARFIELD AVE
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3423
Country	:	US
Telephone Number	:	231-941-4090
Fax Number	:	231-941-4048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/09/2007

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