Provider Demographics
NPI:1043308638
Name:FRISCHE, JOHN ROBIN (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBIN
Last Name:FRISCHE
Suffix:
Gender:M
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:PO BOX 385
Mailing Address - Street 2:
Mailing Address - City:BOTKINS
Mailing Address - State:OH
Mailing Address - Zip Code:45306-0385
Mailing Address - Country:US
Mailing Address - Phone:937-693-8151
Mailing Address - Fax:
Practice Address - Street 1:208 W. STATE ST.
Practice Address - Street 2:
Practice Address - City:BOTKINS
Practice Address - State:OH
Practice Address - Zip Code:45306-0385
Practice Address - Country:US
Practice Address - Phone:937-693-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice