Provider Demographics
NPI:1205055068
Name:FREI, NEWELL RICHARD (DDS MS)
Entity type:Individual
Prefix:DR
First Name:NEWELL
Middle Name:RICHARD
Last Name:FREI
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:FREI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MS
Mailing Address - Street 1:2430 E HARMON
Mailing Address - Street 2:#3
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121
Mailing Address - Country:US
Mailing Address - Phone:702-735-4169
Mailing Address - Fax:702-735-8697
Practice Address - Street 1:2430 E HARMON
Practice Address - Street 2:#3
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121
Practice Address - Country:US
Practice Address - Phone:702-735-4169
Practice Address - Fax:702-735-8697
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV06611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics