Provider Demographics
NPI:1679660609
Name:FRAME, STEPHEN J
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:FRAME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366949
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6949
Mailing Address - Country:US
Mailing Address - Phone:787-250-0907
Mailing Address - Fax:787-756-5704
Practice Address - Street 1:440 FD ROOSEVELT AVE.
Practice Address - Street 2:OFF 506
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-250-0907
Practice Address - Fax:787-756-5704
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics