Healthcare Provider Details

I. General information

NPI: 1124961768
Provider Name (Legal Business Name): CARL FRICKE DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29811 US 2
SULTAN WA
98294-8672
US

IV. Provider business mailing address

29811 US 2
SULTAN WA
98294-8672
US

V. Phone/Fax

Practice location:
  • Phone: 360-454-4544
  • Fax: 360-793-2213
Mailing address:
  • Phone: 360-454-4544
  • Fax: 360-793-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL C FRICKE
Title or Position: OWNER
Credential: DDS
Phone: 360-454-4544