Provider Demographics
NPI:1558571588
Name:NAGY, FRANK DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DAVID
Last Name:NAGY
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 1:15351 17 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5714
Mailing Address - Country:US
Mailing Address - Phone:586-263-6000
Mailing Address - Fax:586-263-9990
Practice Address - Street 1:15351 17 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5714
Practice Address - Country:US
Practice Address - Phone:586-263-6000
Practice Address - Fax:586-263-9990
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14876122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI629684OtherUNITED CONCORDIA ID
MI14876OtherSTATE LICENSE NUMBER