MEDICARE: DR. ROBERT DURAND FRAZIER DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	21312	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598793887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DURAND FRAZIER DDS

Provider Business Mailing Address
First Line	:	5538 PHILADELPHIA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-3062
Country	:	US
Telephone Number	:	937-277-9387
Fax Number	:	937-277-9388

Provider Business Practice Location Address
First Line	:	7111 N MAIN ST STE 30
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2558
Country	:	US
Telephone Number	:	927-277-9387
Fax Number	:	937-277-9388

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	06/24/2024

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