Provider Demographics
NPI:1144873332
Name:FRASER, JAMES M II (DDS MS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:FRASER
Suffix:II
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:3790 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-1591
Mailing Address - Country:US
Mailing Address - Phone:810-650-5834
Mailing Address - Fax:
Practice Address - Street 1:2388 COLE ST STE 103
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7009
Practice Address - Country:US
Practice Address - Phone:810-650-5834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010223731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics