Provider Demographics
NPI:1629137856
Name:FAGER, FRANK KARL (DDS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:KARL
Last Name:FAGER
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 1:19864 E LONG PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1978
Mailing Address - Country:US
Mailing Address - Phone:303-693-8372
Mailing Address - Fax:
Practice Address - Street 1:3545 S TAMARAC DR STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1428
Practice Address - Country:US
Practice Address - Phone:303-770-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO058881223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics