Individual
DR. JERRY EVAN FRASURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
400 N MAIN ST, CEDARVILLE, OH 45314
(937) 766-5207
(937) 766-9303
Mailing address
400 N MAIN ST, CEDARVILLE, OH 45314
(937) 766-5207
(937) 766-9303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15428
OH
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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