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NPI Code Detail

MEDICARE: DR. FRED E BOKEL DDS

MEDICARE: DR. FRED E BOKEL 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
11223G0001XGeneral Practice Dentistry1200888IN

General Provider Information

NPI Number : 1356523047
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRED E BOKEL DDS
Provider Business Mailing Address
First Line : 5730 FALLS DR
Second Line : SUITE 200
City : FORT WAYNE
State : IN
Zip : 46804-7147
Country : US
Telephone Number : 260-436-5718
Fax Number : 260-436-5915
Provider Business Practice Location Address
First Line : 5730 FALLS DR
Second Line : SUITE 200
City : FORT WAYNE
State : IN
Zip : 46804-7147
Country : US
Telephone Number : 260-436-5718
Fax Number : 260-436-5915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2007
Last Update Date : 12/04/2007

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Directions to “ DR. FRED E BOKEL DDS” Practice Location

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