Provider Demographics
NPI:1588798771
Name:THOMAS K. FRAWLEY, DDS, PC
Entity Type:Organization
Organization Name:THOMAS K. FRAWLEY, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:FRAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-649-7718
Mailing Address - Street 1:223 MAIN ST
Mailing Address - Street 2:PO BOX 545
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-4928
Mailing Address - Country:US
Mailing Address - Phone:716-649-7718
Mailing Address - Fax:
Practice Address - Street 1:223 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-4928
Practice Address - Country:US
Practice Address - Phone:716-649-7718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04265911223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC58864Medicare ID - Type Unspecified