Individual
DR. KYLE BRYAN FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
675 BALTIMORE DR, WILKES BARRE, PA 18702-7900
(570) 808-5626
(570) 808-6352
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27097
TX
1223P0106X
Oral and Maxillofacial Pathology Dentistry
27097
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
27097
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS043990
PA
Other
Enumeration date
06/23/2011
Last updated
09/13/2023
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