Provider Demographics
NPI:1033374269
Name:FRANK AVASON III, DMD, MS, PA
Entity Type:Organization
Organization Name:FRANK AVASON III, DMD, MS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:AVASON
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-820-9797
Mailing Address - Street 1:7476 WATERSIDE LOOP RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-7679
Mailing Address - Country:US
Mailing Address - Phone:704-820-9797
Mailing Address - Fax:
Practice Address - Street 1:7476 WATERSIDE LOOP RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-7679
Practice Address - Country:US
Practice Address - Phone:704-820-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7101261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental