Provider Demographics
NPI:1114056926
Name:ALTICK, FRANK L (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:L
Last Name:ALTICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2707
Mailing Address - Country:US
Mailing Address - Phone:650-327-1787
Mailing Address - Fax:650-327-7971
Practice Address - Street 1:824 BRYANT ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2707
Practice Address - Country:US
Practice Address - Phone:650-327-1787
Practice Address - Fax:650-327-7971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice