Provider Demographics
NPI:1053630194
Name:FROUNFELTER, ADAM LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LEE
Last Name:FROUNFELTER
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 1:611 HARRIET ST STE 408
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1781
Mailing Address - Country:US
Mailing Address - Phone:812-423-6113
Mailing Address - Fax:
Practice Address - Street 1:611 HARRIET ST STE 408
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1781
Practice Address - Country:US
Practice Address - Phone:812-423-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011448A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist