Provider Demographics
NPI:1114132552
Name:MASTALERZ, FRANK JOSEPH JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:MASTALERZ
Suffix:JR
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 1:2432 E. ALPINE DR.
Mailing Address - Street 2:
Mailing Address - City:TERRA ALTA
Mailing Address - State:WV
Mailing Address - Zip Code:26764
Mailing Address - Country:US
Mailing Address - Phone:443-605-5529
Mailing Address - Fax:
Practice Address - Street 1:DREAM DENTAL
Practice Address - Street 2:323 E. OAK ST.
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550
Practice Address - Country:US
Practice Address - Phone:310-334-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD69131223G0001X, 122300000X
WV2729122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist