Provider Demographics
NPI:1891008066
Name:FREY, JOHN KURT II (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KURT
Last Name:FREY
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:727 31-W BYPASS
Mailing Address - Street 2:SUITE 106-B
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101
Mailing Address - Country:US
Mailing Address - Phone:270-782-1444
Mailing Address - Fax:270-796-9113
Practice Address - Street 1:727 US 31W BYP
Practice Address - Street 2:106-B
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4963
Practice Address - Country:US
Practice Address - Phone:270-782-1444
Practice Address - Fax:270-796-9113
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY88861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice