Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | CT5238 | CT |
NPI | 1063802221 |
---|---|
Provider Name | Benjanin M Frank |
First Address | Danbury, CT 06810-1603 |
Second Address | Danbury, CT 06810-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2015 |
Last Update Date | 27/01/2015 |