Provider Demographics
NPI:1124175054
Name:FRAZEE, DARLYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:DARLYNE
Middle Name:
Last Name:FRAZEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38430 CROSSBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8172
Mailing Address - Country:US
Mailing Address - Phone:440-942-6816
Mailing Address - Fax:
Practice Address - Street 1:36001 EUCLID AVE
Practice Address - Street 2:#A-3
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4643
Practice Address - Country:US
Practice Address - Phone:440-946-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice