Provider Demographics
NPI:1578689915
Name:FRASER, THOMAS FRANCIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:FRASER
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 1:5651 CORPORATE WAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2020
Mailing Address - Country:US
Mailing Address - Phone:561-689-0872
Mailing Address - Fax:561-683-9262
Practice Address - Street 1:5651 CORPORATE WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2020
Practice Address - Country:US
Practice Address - Phone:561-689-0872
Practice Address - Fax:561-683-9262
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL114011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice