Provider Demographics
NPI:1417174939
Name:FRANK, RICHARD WINTHROP (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WINTHROP
Last Name:FRANK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SOLJER DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-4313
Mailing Address - Country:US
Mailing Address - Phone:860-440-2836
Mailing Address - Fax:
Practice Address - Street 1:909 HARTFORD TPKE
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4267
Practice Address - Country:US
Practice Address - Phone:860-440-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI024141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice