Healthcare Provider Details

I. General information

NPI: 1770314486
Provider Name (Legal Business Name): FRAITES DDS AND TECLE DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 VISION DR
APEX NC
27523
US

IV. Provider business mailing address

1001 VISION DR
APEX NC
27523
US

V. Phone/Fax

Practice location:
  • Phone: 919-230-7761
  • Fax: 919-415-1386
Mailing address:
  • Phone: 919-230-7761
  • Fax: 919-415-1386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BINI TECLE
Title or Position: OWNER
Credential:
Phone: 919-230-7761