Provider Demographics
NPI:1609848910
Name:AVASON, FRANK III (DMD MS PA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:AVASON
Suffix:III
Gender:M
Credentials:DMD MS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7476 WATERSIDE LOOP RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-7593
Mailing Address - Country:US
Mailing Address - Phone:704-820-9797
Mailing Address - Fax:704-820-9729
Practice Address - Street 1:7476 WATERSIDE LOOP RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-7593
Practice Address - Country:US
Practice Address - Phone:704-820-9797
Practice Address - Fax:704-820-9729
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice