MEDICARE: DR. JAMES F FRUGE JR. 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	3141	LA

General Provider Information

NPI Number	:	1649302639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES F FRUGE JR. DDS

Provider Business Mailing Address
First Line	:	12061 BRICKSOME AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2339
Country	:	US
Telephone Number	:	225-292-6001
Fax Number	:	225-292-7210

Provider Business Practice Location Address
First Line	:	12061 BRICKSOME AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2339
Country	:	US
Telephone Number	:	225-292-6001
Fax Number	:	225-292-7210

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

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