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General NPI Number Information
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NPI Number | 1821907833
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Entity Type | Organization
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Legal Business Name | FREDERICK W BOURGEOIS DDS INC
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 5400 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214-1117
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Country | US
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Telephone | 614-436-2817
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Fax | 614-436-3954
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Provider Business Mailing Address
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Address Line | 5400 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214-1117
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Country | US
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Telephone | 614-436-2817
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Fax | 614-436-3954
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Authorized Official
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Title or Position | TREASURER
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Name | BRIAN BOURGEOIS
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Credential | DDS
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Telephone | 614-436-2817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | NULL
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