Provider Demographics
NPI:1821325903
Name:DUNKIRK DENTAL GROUP
Entity Type:Organization
Organization Name:DUNKIRK DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRAZER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-257-2400
Mailing Address - Street 1:2880 DUNKIRK WAY STE 202
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-9103
Mailing Address - Country:US
Mailing Address - Phone:410-257-2400
Mailing Address - Fax:410-257-0628
Practice Address - Street 1:2880 DUNKIRK WAY STE 202
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-9103
Practice Address - Country:US
Practice Address - Phone:410-257-2400
Practice Address - Fax:410-257-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD41601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1326110099OtherNPI
MD1174695837OtherNPI