Provider Demographics
NPI:1114015088
Name:FRANKEL, BENNETT FRANK (DMD)
Entity Type:Individual
Prefix:DR
First Name:BENNETT
Middle Name:FRANK
Last Name:FRANKEL
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 1:55 STOAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678
Mailing Address - Country:US
Mailing Address - Phone:410-535-2416
Mailing Address - Fax:301-855-1287
Practice Address - Street 1:55 STOAKLEY RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678
Practice Address - Country:US
Practice Address - Phone:410-535-2416
Practice Address - Fax:301-855-1287
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6087204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR180BFOtherBCBS MD
DC97970001OtherBCBS NCA
T59655Medicare UPIN
DC97970001OtherBCBS NCA