Individual
JOSHUA FRAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 SMITH AVE UNIT 5, SHALLOTTE, NC 28470-4756
(980) 296-2473
Mailing address
17130 VAN BUREN BLVD, RIVERSIDE, CA 92504-5905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13427
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2023
Last updated
08/03/2023
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