Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 04018 | MD |
NPI | 1063484608 |
---|---|
Provider Name | Dr. John Anthony Frensilli |
First Address | Rockville, MD 20850-4127 |
Second Address | Rockville, MD 20850-4127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 08/07/2007 |