Provider Demographics
NPI:1336400126
Name:FRICKER, EAMON ROARK (DMD)
Entity Type:Individual
Prefix:DR
First Name:EAMON
Middle Name:ROARK
Last Name:FRICKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3758
Mailing Address - Country:US
Mailing Address - Phone:610-434-9660
Mailing Address - Fax:
Practice Address - Street 1:123 N 13TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3758
Practice Address - Country:US
Practice Address - Phone:610-434-9660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038184122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist