Provider Demographics
NPI:1760501886
Name:ROSSI, FRANK JARRETT (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JARRETT
Last Name:ROSSI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 REGENT CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-4435
Mailing Address - Country:US
Mailing Address - Phone:290-463-2287
Mailing Address - Fax:209-463-1125
Practice Address - Street 1:306 REGENT CT
Practice Address - Street 2:SUITE 2
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-4435
Practice Address - Country:US
Practice Address - Phone:290-463-2287
Practice Address - Fax:209-463-1125
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18180122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist