Provider Demographics
NPI:1780850909
Name:FOOTE, FREDERICK FRANKLYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:FRANKLYN
Last Name:FOOTE
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 1:7705 ATLANTIC AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CUDAHY
Mailing Address - State:CA
Mailing Address - Zip Code:90201-5085
Mailing Address - Country:US
Mailing Address - Phone:323-773-1664
Mailing Address - Fax:323-773-7365
Practice Address - Street 1:7705 ATLANTIC AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CUDAHY
Practice Address - State:CA
Practice Address - Zip Code:90201-5085
Practice Address - Country:US
Practice Address - Phone:323-773-1664
Practice Address - Fax:323-773-7365
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56617122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist