Provider Demographics
NPI:1316965932
Name:FRYE, JEFFREY P (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:FRYE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MURRAY AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1657
Mailing Address - Country:US
Mailing Address - Phone:412-422-9222
Mailing Address - Fax:412-422-2684
Practice Address - Street 1:1900 MURRAY AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1657
Practice Address - Country:US
Practice Address - Phone:412-422-9222
Practice Address - Fax:412-422-2684
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-021153-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice