MEDICARE: DR. GAIL E FRICK DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	27131	CA

General Provider Information

NPI Number	:	1174622724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL E FRICK DMD

Provider Business Mailing Address
First Line	:	1802 SAN MIGUEL DRIVE
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-8606
Country	:	US
Telephone Number	:	925-934-5526
Fax Number	:	925-934-4273

Provider Business Practice Location Address
First Line	:	1802 SAN MIGUEL DRIVE
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-8606
Country	:	US
Telephone Number	:	925-934-5526
Fax Number	:	925-934-4273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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