Provider Demographics
NPI:1700050887
Name:RICHARD S FRONCZAK DDS PC
Entity Type:Organization
Organization Name:RICHARD S FRONCZAK DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:FRONCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:303-447-0393
Mailing Address - Street 1:2300 CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5619
Mailing Address - Country:US
Mailing Address - Phone:303-447-0393
Mailing Address - Fax:303-440-0198
Practice Address - Street 1:2300 CANYON BLVD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5619
Practice Address - Country:US
Practice Address - Phone:303-447-0393
Practice Address - Fax:303-440-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty