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General NPI Number Information
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NPI Number | 1720578669
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Entity Type | Individual
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Provider Name | NATHANIEL DAVID FRYE DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 3075 SMITH RD STE 201
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City | FAIRLAWN
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State | OH
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Zip | 44333-4454
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Country | US
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Telephone | 330-666-0400
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Fax | 330-666-0130
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Provider Business Mailing Address
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Address Line | 4316 CHESTNUT RD
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City | INDEPENDENCE
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State | OH
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Zip | 44131-3760
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Country | US
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Telephone | 814-758-0476
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.025378
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.025378
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License Number State | OH
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