Provider Demographics
NPI:1134453152
Name:FRYE, ANGEL MARIE (RDH)
Entity type:Individual
Prefix:MISS
First Name:ANGEL
Middle Name:MARIE
Last Name:FRYE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13706 W BELL RD
Mailing Address - Street 2:STE 2
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374
Mailing Address - Country:US
Mailing Address - Phone:623-584-9910
Mailing Address - Fax:623-584-9940
Practice Address - Street 1:5115 N DYSART RD
Practice Address - Street 2:STE 218
Practice Address - City:LITCHFIELD
Practice Address - State:AZ
Practice Address - Zip Code:85340
Practice Address - Country:US
Practice Address - Phone:623-536-0900
Practice Address - Fax:623-536-0920
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ6685122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist