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General NPI Number Information
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NPI Number | 1740477553
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Entity Type | Individual
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Provider Name | ROBERT WILLIAM FRARE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 345 E 24TH ST
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City | NEW YORK
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State | NY
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Zip | 10010-4020
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Country | US
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Telephone | 212-998-9544
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Fax |
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Provider Business Mailing Address
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Address Line | 68 REGAN LN
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City | VOORHEES
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State | NJ
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Zip | 08043-4146
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Country | US
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Telephone | 856-424-2190
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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 | 058926
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS035642
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DI02264100
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License Number State | NJ
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