Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 375980 | FL |
NPI | 1003356460 |
---|---|
Provider Name | Dr. Caylin Frye |
First Address | Washington, DC 20002-2373 |
Second Address | Washington, DC 20002-2373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2017 |
Last Update Date | 06/03/2017 |