Provider Demographics
NPI:1174818629
Name:FRANDSEN, BENJAMIN RONALD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:RONALD
Last Name:FRANDSEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 E 800 N STE 101
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-4436
Mailing Address - Country:US
Mailing Address - Phone:801-375-3355
Mailing Address - Fax:801-224-7374
Practice Address - Street 1:1375 E 800 N STE 101
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-4436
Practice Address - Country:US
Practice Address - Phone:801-375-3355
Practice Address - Fax:801-224-7374
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7721150-99211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics