Organization
NORTHEAST ORAL AND MAXILLOFACIAL SURGERY
Active
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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