Provider Demographics
NPI:1770656639
Name:PORTALE, FRANK A (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:PORTALE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1610 N EL DORADO ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5930
Mailing Address - Country:US
Mailing Address - Phone:209-464-7658
Mailing Address - Fax:209-464-4019
Practice Address - Street 1:1610 N EL DORADO ST
Practice Address - Street 2:SUITE 7
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5930
Practice Address - Country:US
Practice Address - Phone:209-464-7658
Practice Address - Fax:209-464-4019
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA269081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice