Provider Demographics
NPI:1497161277
Name:FRONTERA, JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FRONTERA
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 1:101 W RIDGELY RD
Mailing Address - Street 2:STE3B
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5101
Mailing Address - Country:US
Mailing Address - Phone:410-252-1900
Mailing Address - Fax:410-252-6546
Practice Address - Street 1:101 W RIDGELY RD
Practice Address - Street 2:STE3B
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5101
Practice Address - Country:US
Practice Address - Phone:410-252-1900
Practice Address - Fax:410-252-6546
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice