Provider Demographics
NPI:1144462649
Name:PANCKO, FRANKLIN X (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:X
Last Name:PANCKO
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 1:13 CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-5828
Mailing Address - Country:US
Mailing Address - Phone:443-939-0942
Mailing Address - Fax:302-678-3228
Practice Address - Street 1:1004 S STATE ST
Practice Address - Street 2:STE 1
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6925
Practice Address - Country:US
Practice Address - Phone:718-920-5993
Practice Address - Fax:718-515-5419
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00012691223D0001X
NY0519941223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223D0001XDental ProvidersDentistDental Public Health