Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS030865L | PA |
NPI | 1043303191 |
---|---|
Provider Name | Dr. Brian N Frey |
First Address | Wyomissing, PA 19610-1208 |
Second Address | Wyomissing, PA 19610-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |