Provider Demographics
NPI:1104932128
Name:FRECH, DEVEK KENT (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DEVEK
Middle Name:KENT
Last Name:FRECH
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2120
Mailing Address - Country:US
Mailing Address - Phone:940-691-1671
Mailing Address - Fax:940-692-6677
Practice Address - Street 1:3621 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2120
Practice Address - Country:US
Practice Address - Phone:940-691-1671
Practice Address - Fax:940-692-6677
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics