Provider Demographics
NPI:1619197860
Name:FRANKLIN, ROBERT LESLIE JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LESLIE
Last Name:FRANKLIN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2431
Mailing Address - Country:US
Mailing Address - Phone:270-769-1622
Mailing Address - Fax:270-766-1044
Practice Address - Street 1:611 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2431
Practice Address - Country:US
Practice Address - Phone:270-769-1622
Practice Address - Fax:270-766-1044
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY75561223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics