Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 06889 | IA |
NPI | 1003996604 |
---|---|
Provider Name | Dr. Frank H Sargent |
First Address | Sioux City, IA 51104-2423 |
Second Address | Sioux City, IA 51104-2423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 15/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0215475 | (05) | IA |