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NPI 1083632483

NPI 1083632483 : BRET R FRYE D.D.S. : MARIETTA, OH

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General NPI Number Information
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    NPI Number           |    1083632483
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    Entity Type          |    Individual 
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    Provider Name        |    BRET R FRYE D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/17/2006
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    Last Update Date     |    10/09/2018
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Provider Practice Location Address
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    Address Line         |    1309 GREENE ST 
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    City                 |    MARIETTA
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    State                |    OH
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    Zip                  |    45750-9172
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    Country              |    US
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    Telephone            |    740-374-0123
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    Fax                  |    740-374-0123
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Provider Business Mailing Address
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    Address Line         |    1309 GREENE ST 
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    City                 |    MARIETTA
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    State                |    OH
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    Zip                  |    45750-9172
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    Country              |    US
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    Telephone            |    740-374-0123
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    Fax                  |    740-376-9985
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    30.019744
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    License Number State |    OH
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