Provider Demographics
NPI:1467678169
Name:GUSSMAN, FRANK PHILIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:PHILIP
Last Name:GUSSMAN
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 1:2217 FOX HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2501
Mailing Address - Country:US
Mailing Address - Phone:310-553-2881
Mailing Address - Fax:310-553-2881
Practice Address - Street 1:2217 FOX HILLS DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2501
Practice Address - Country:US
Practice Address - Phone:310-553-2881
Practice Address - Fax:310-553-2881
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADJ0229761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice