Provider Demographics
NPI:1588683916
Name:TERRACINA, FRANK A JR (DMD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:A
Last Name:TERRACINA
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:290 MERCHANTS SQ
Mailing Address - Street 2:SUITE A
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-5029
Mailing Address - Country:US
Mailing Address - Phone:770-505-6400
Mailing Address - Fax:770-505-6444
Practice Address - Street 1:290 MERCHANTS SQ
Practice Address - Street 2:SUITE A
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-5029
Practice Address - Country:US
Practice Address - Phone:770-505-6400
Practice Address - Fax:770-505-6444
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAGA 113001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice