Provider Demographics
NPI:1760599039
Name:SAMMIS, FRANK CONKLIN III (DDS MPH)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:CONKLIN
Last Name:SAMMIS
Suffix:III
Gender:M
Credentials:DDS MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7744 BROADWAY
Mailing Address - Street 2:SUITE #203
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3262
Mailing Address - Country:US
Mailing Address - Phone:210-828-4990
Mailing Address - Fax:210-828-0555
Practice Address - Street 1:7744 BROADWAY
Practice Address - Street 2:SUITE #203
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3262
Practice Address - Country:US
Practice Address - Phone:210-828-4990
Practice Address - Fax:210-828-0555
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice