Organization
FRYE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK O NEAL FRYE (PRESIDENT DENTIST)
(314) 863-3772
Entity
Organization
Contact information
Practice address
7843 OLIVE BLVD, ST LOUIS, MO 63130
(314) 863-3772
(314) 863-3857
Mailing address
7843 OLIVE BLVD, ST LOUIS, MO 63130
(314) 863-3772
(314) 863-3857
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE015374
MO
Other
Enumeration date
04/24/2006
Last updated
08/22/2020
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