Provider Demographics
NPI:1275658049
Name:WADE, FRANK ANDERSON III (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANDERSON
Last Name:WADE
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:F.
Other - Middle Name:ANDERSON
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:204 N HAMILTON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2662
Mailing Address - Country:US
Mailing Address - Phone:804-358-8204
Mailing Address - Fax:
Practice Address - Street 1:204 N HAMILTON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2662
Practice Address - Country:US
Practice Address - Phone:804-358-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010059751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice