Provider Demographics
NPI:1467865618
Name:FRANKLIN, MARK A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:FRANKLIN
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 1:453 DIXON RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1949
Mailing Address - Country:US
Mailing Address - Phone:518-792-1108
Mailing Address - Fax:518-798-4670
Practice Address - Street 1:453 DIXON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1949
Practice Address - Country:US
Practice Address - Phone:518-792-1108
Practice Address - Fax:518-798-4670
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN4384122300000X
NY057998122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist