Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | G1-0001269 | DE |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 051994 | NY |
NPI | 1144462649 |
---|---|
Provider Name | Dr. Franklin X Pancko |
First Address | Dover, DE 19901-5828 |
Second Address | Dover, DE 19901-6925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 18/10/2018 |