Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS016644L | PA |
NPI | 1023431855 |
---|---|
Provider Name | Frank Bishop |
First Address | Norristown, PA 19403-4250 |
Second Address | Norristown, PA 19403-4250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2014 |
Last Update Date | 30/01/2014 |