Individual
DR. JOHN FRAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
700 E WALNUT ST, GREEN BAY, WI 54301-4052
(920) 432-0634
Mailing address
700 E WALNUT ST, GREEN BAY, WI 54301-4052
(920) 432-0634
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2345-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33389500
—
WI
Enumeration date
04/24/2007
Last updated
07/08/2007
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