Provider Demographics
NPI:1508903709
Name:FRINO, JR, GERALD B (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:B
Last Name:FRINO, JR
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 1:287 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1726
Mailing Address - Country:US
Mailing Address - Phone:973-835-4969
Mailing Address - Fax:973-835-0103
Practice Address - Street 1:287 BOULEVARD
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1726
Practice Address - Country:US
Practice Address - Phone:973-835-4969
Practice Address - Fax:973-835-0103
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI16986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist