Provider Demographics
NPI:1073683819
Name:FRANK T RASTIGUE D.D.S.,P.C.
Entity Type:Organization
Organization Name:FRANK T RASTIGUE D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:T
Authorized Official - Last Name:RASTIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:586-469-1133
Mailing Address - Street 1:60 DICKINSON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-5925
Mailing Address - Country:US
Mailing Address - Phone:586-469-1133
Mailing Address - Fax:586-469-0318
Practice Address - Street 1:60 DICKINSON ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-5925
Practice Address - Country:US
Practice Address - Phone:586-469-1133
Practice Address - Fax:586-469-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty