Individual
DR. DENNIS L FREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(912) 285-4616
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
38760
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000630792A
—
GA
01
—
040009455
RR PROVIDER #
GA
Enumeration date
10/10/2006
Last updated
11/08/2019
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