Provider Demographics
NPI:1205021748
Name:FRANK A DELATOUR DDS PC
Entity Type:Organization
Organization Name:FRANK A DELATOUR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELATOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:703-273-8224
Mailing Address - Street 1:10090 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3486
Mailing Address - Country:US
Mailing Address - Phone:703-273-8224
Mailing Address - Fax:
Practice Address - Street 1:10090 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3486
Practice Address - Country:US
Practice Address - Phone:703-273-8224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty