Provider Demographics
NPI:1699777631
Name:FREY, ROBERT DON (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DON
Last Name:FREY
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 1:104 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-1245
Mailing Address - Country:US
Mailing Address - Phone:419-826-2881
Mailing Address - Fax:419-826-0333
Practice Address - Street 1:104 MILLER AVE
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-1245
Practice Address - Country:US
Practice Address - Phone:419-826-2881
Practice Address - Fax:419-826-0333
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30 01 79291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice