Provider Demographics
NPI:1679913453
Name:FICKAS, FRANK DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DAVID
Last Name:FICKAS
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:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47629-0185
Mailing Address - Country:US
Mailing Address - Phone:812-853-3313
Mailing Address - Fax:812-858-0087
Practice Address - Street 1:10655 STATE ROAD 662
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630
Practice Address - Country:US
Practice Address - Phone:812-853-3313
Practice Address - Fax:812-858-0087
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012011A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice