Frazier, John
Frazier, John is an sole proprietor health care provider with primary practice located at 700 E Walnut St , Green Bay WI 54301-4052. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Frazier, John can be contacted via phone (920) 432-0634.Contact Information
Primary practice address
700 E Walnut St
Green Bay WI 54301-4052
Phone: (920) 432-0634
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 2345-015 | Wisconsin |
Profile Details
| NPI number | 1831318658 |
|---|---|
| LBN Legal business name | Frazier, John |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 24th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831318658 | NPPES |
| Wisconsin | MEDICAID | 33389500 |
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