Provider Demographics
NPI:1821118985
Name:FREI DENTISTRY P.A.
Entity Type:Organization
Organization Name:FREI DENTISTRY P.A.
Other - Org Name:BULVERDE NORTH FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FREI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-438-2273
Mailing Address - Street 1:22101 STATE HIGHWAY 46 W
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6771
Mailing Address - Country:US
Mailing Address - Phone:830-438-2273
Mailing Address - Fax:830-438-3183
Practice Address - Street 1:22101 STATE HIGHWAY 46 W
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6771
Practice Address - Country:US
Practice Address - Phone:830-438-2273
Practice Address - Fax:830-438-3183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty