Individual
FREDERIC P THRASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
815 WEST AVE, ALAMOSA, CO 81101-3028
(719) 589-4771
(719) 589-4258
Mailing address
815 WEST AVE, ALAMOSA, CO 81101-3028
(719) 589-4771
(719) 589-4258
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7025
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7025
STATE LICENSE
CO
Enumeration date
07/12/2007
Last updated
07/12/2007
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