MEDICARE: DR. FRANK ANDERSON WADE III D.D.S.

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	1223G0001X	General Practice Dentistry	0401005975	VA

General Provider Information

NPI Number	:	1275658049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK ANDERSON WADE III D.D.S.

Provider Business Mailing Address
First Line	:	204 N HAMILTON ST
Second Line	:	SUITE 1
City	:	RICHMOND
State	:	VA
Zip	:	23221-2662
Country	:	US
Telephone Number	:	804-358-8204
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 N HAMILTON ST
Second Line	:	SUITE 1
City	:	RICHMOND
State	:	VA
Zip	:	23221-2662
Country	:	US
Telephone Number	:	804-358-8204
Fax Number	:

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/30/2009

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