Provider Demographics
NPI:1154300200
Name:FRUGOLI, LARRY S (DMD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:S
Last Name:FRUGOLI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 CAUGHLIN CROSSING
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509
Mailing Address - Country:US
Mailing Address - Phone:775-329-2995
Mailing Address - Fax:775-329-3671
Practice Address - Street 1:1010 CAUGHLIN CROSSING
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509
Practice Address - Country:US
Practice Address - Phone:775-329-2995
Practice Address - Fax:775-329-3671
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist