Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 22DI02505300 | NJ |
Y | 1223X0400X | Orthodontists | 22DI02505300 | NJ |
NPI | 1003157793 |
---|---|
Provider Name | Dr. Eric David Frank |
First Address | Succasunna, NJ 07876 |
Second Address | Succasunna, NJ 07876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2013 |
Last Update Date | 16/03/2017 |