Provider Demographics
NPI:1174695837
Name:FRAZER, DAVID DUNCAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DUNCAN
Last Name:FRAZER
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 1:4012 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20732-3105
Mailing Address - Country:US
Mailing Address - Phone:410-257-6198
Mailing Address - Fax:
Practice Address - Street 1:2880 DUNKIRK WAY STE 202
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-9103
Practice Address - Country:US
Practice Address - Phone:410-257-2400
Practice Address - Fax:410-257-0628
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD62961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice