Provider Demographics
NPI:1457464935
Name:FRAZIER, ROBERT TIMOTHY JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:FRAZIER
Suffix:JR
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 1:70 REMSEN ST
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047
Mailing Address - Country:US
Mailing Address - Phone:518-237-0700
Mailing Address - Fax:518-237-0725
Practice Address - Street 1:70 REMSEN ST
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047
Practice Address - Country:US
Practice Address - Phone:518-237-0700
Practice Address - Fax:518-237-0725
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist