Provider Demographics
NPI:1073725735
Name:GRANICH, FRANK C (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:C
Last Name:GRANICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 HAMILTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:WESCOSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9648
Mailing Address - Country:US
Mailing Address - Phone:610-395-3541
Mailing Address - Fax:610-395-6863
Practice Address - Street 1:5940 HAMILTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9648
Practice Address - Country:US
Practice Address - Phone:610-395-3541
Practice Address - Fax:610-395-6863
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027180L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS027180LOtherDENTAL LICENSE #