Provider Demographics
NPI:1679834782
Name:FRAZEE, DENNIS STEPHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:STEPHEN
Last Name:FRAZEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 TOWN CENTER RD S
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-2321
Mailing Address - Country:US
Mailing Address - Phone:317-584-3540
Mailing Address - Fax:317-584-3527
Practice Address - Street 1:100 TOWN CENTER RD S
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-2321
Practice Address - Country:US
Practice Address - Phone:317-584-3540
Practice Address - Fax:317-584-3527
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011820A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice