Provider Demographics
NPI:1770314486
Name:FRAITES DDS AND TECLE DDS PLLC
Entity type:Organization
Organization Name:FRAITES DDS AND TECLE DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BINI
Authorized Official - Middle Name:
Authorized Official - Last Name:TECLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-230-7761
Mailing Address - Street 1:1001 VISION DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523
Mailing Address - Country:US
Mailing Address - Phone:919-230-7761
Mailing Address - Fax:919-415-1386
Practice Address - Street 1:1001 VISION DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523
Practice Address - Country:US
Practice Address - Phone:919-230-7761
Practice Address - Fax:919-415-1386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty