Provider Demographics
NPI:1487839098
Name:FROESCHLE, MARY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:LYNN
Last Name:FROESCHLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40TH AND HOLDREGE
Mailing Address - Street 2:COLLEGE OF DENTISTRY
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68583-0740
Mailing Address - Country:US
Mailing Address - Phone:402-472-7993
Mailing Address - Fax:
Practice Address - Street 1:40TH AND HOLDREGE
Practice Address - Street 2:COLLEGE OF DENTISTRY
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-0740
Practice Address - Country:US
Practice Address - Phone:402-472-7993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE59441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice