Provider Demographics
NPI:1457317869
Name:FRADE, ALEXANDRE PINHEIRO (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRE
Middle Name:PINHEIRO
Last Name:FRADE
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 1:751 LOMBARDI CT
Mailing Address - Street 2:SUITE #A
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-6793
Mailing Address - Country:US
Mailing Address - Phone:707-547-2233
Mailing Address - Fax:707-547-2230
Practice Address - Street 1:751 LOMBARDI CT
Practice Address - Street 2:SUITE #A
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-6793
Practice Address - Country:US
Practice Address - Phone:707-547-2233
Practice Address - Fax:707-547-2230
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist