Provider Demographics
NPI:1265882740
Name:TRECARTIN-FROST, COLLEEN (DMD)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:
Last Name:TRECARTIN-FROST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 STATE ROUTE 31
Mailing Address - Street 2:SUITE 212
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5795
Mailing Address - Country:US
Mailing Address - Phone:908-894-8294
Mailing Address - Fax:
Practice Address - Street 1:111 STATE ROUTE 31
Practice Address - Street 2:SUITE 212
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5795
Practice Address - Country:US
Practice Address - Phone:908-894-8294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026428001223G0001X
NJ22DI026438011223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223G0001XDental ProvidersDentistGeneral Practice