Provider Demographics
NPI:1023397080
Name:FRONHEISER, REBECCA LYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYN
Last Name:FRONHEISER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 CLUB POND RD
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-4000
Mailing Address - Country:US
Mailing Address - Phone:910-248-3680
Mailing Address - Fax:
Practice Address - Street 1:2040 CLUB POND RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-4000
Practice Address - Country:US
Practice Address - Phone:910-248-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10808122300000X
MI2901020388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist