Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 3016WI | WI |
NPI | 1225077910 |
---|---|
Provider Name | Dr. Barry R. Franzen |
First Address | West Allis, WI 53227-1255 |
Second Address | West Allis, WI 53227-1255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T-61944 | (02) | WI |