MEDICARE: DR. SCOTT JOSEPH FRIDRICH D.D.S.

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	122300000X	Dentist	104873	CO

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	:	1932372745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT JOSEPH FRIDRICH D.D.S.

Provider Business Mailing Address
First Line	:	1120 ALPINE AVE STE C
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3414
Country	:	US
Telephone Number	:	303-443-4416
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 ALPINE AVE STE C
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3414
Country	:	US
Telephone Number	:	303-443-4416
Fax Number	:

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

Provider Enumeration Date	:	04/12/2008
Last Update Date	:	03/15/2026

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Directions to “ DR. SCOTT JOSEPH FRIDRICH D.D.S.” Practice Location

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