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General NPI Number Information
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NPI Number | 1396275681
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Entity Type | Individual
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Provider Name | EVAN FRISBEE DMD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 06/19/2017
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Provider Practice Location Address
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Address Line | 938 W CHURCH ST
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City | JASPER
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State | GA
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Zip | 30143-1496
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Country | US
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Telephone | 706-862-1769
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Fax |
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Provider Business Mailing Address
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Address Line | 549 E CHEROKEE CT
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City | WOODSTOCK
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State | GA
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Zip | 30188-1967
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Country | US
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Telephone |
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Fax |
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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 | DN015393
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License Number State | GA
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