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Organization
J TERRY FREY DDS PC
Active
Organization
J TERRY FREY DDS PC
Active
Other names
Advanced Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES TERRY FREY DDS (OWNER PRESIDENT)
(812) 346-6884
Entity
Organization
Contact information
Practice address
623 N STATE ST, NORTH VERNON, IN 47265
(812) 346-6884
(812) 346-1717
Mailing address
PO BOX 1008, NORTH VERNON, IN 47265-5008
(812) 346-6884
(812) 346-1717
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006939
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200271690A
—
IN
Enumeration date
09/06/2006
Last updated
06/07/2012
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