Provider Demographics
NPI:1649395062
Name:FRIER, JAMES WILLARD (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLARD
Last Name:FRIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:ANGELS CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95222-0939
Mailing Address - Country:US
Mailing Address - Phone:209-754-6240
Mailing Address - Fax:209-754-6274
Practice Address - Street 1:12150 NEW YORK RANCH RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-9407
Practice Address - Country:US
Practice Address - Phone:209-257-2460
Practice Address - Fax:209-257-2464
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist