Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 3074-98 | MS |
NPI | 1073643789 |
---|---|
Provider Name | Dr. Christopher P Frigo |
First Address | Bay St Louis, MS 39520-2915 |
Second Address | Gulfport, MS 39507-1864 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |