Organization
NORTHEAST ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ALLEN FRASER DDS MS (OWNER)
(614) 471-6600
Entity
Organization
Contact information
Practice address
463 WATERBURY COURT, SUITE A, GAHANNA, OH 43230
(614) 471-6600
(614) 471-6660
Mailing address
463 WATERBURY COURT, SUITE A, GAHANNA, OH 43230
(614) 471-6600
(614) 471-6660
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/26/2006
Last updated
08/22/2020
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