Provider Demographics
NPI:1205833829
Name:FRELS, JOHN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:FRELS
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 576
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78164-0576
Mailing Address - Country:US
Mailing Address - Phone:361-564-2239
Mailing Address - Fax:361-564-3703
Practice Address - Street 1:1707 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:YORKTOWN
Practice Address - State:TX
Practice Address - Zip Code:78164-5127
Practice Address - Country:US
Practice Address - Phone:361-564-2239
Practice Address - Fax:361-564-3703
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice