Provider Demographics
NPI:1891830212
Name:FRUGE, ANDRE MAURICE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:MAURICE
Last Name:FRUGE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12061 BRICKSOME AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2339
Mailing Address - Country:US
Mailing Address - Phone:225-292-6991
Mailing Address - Fax:225-292-7210
Practice Address - Street 1:12061 BRICKSOME AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2339
Practice Address - Country:US
Practice Address - Phone:225-292-6991
Practice Address - Fax:225-292-7210
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics