Provider Demographics
NPI:1790811263
Name:FRANKE, III, FREDERICK FERD (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:FERD
Last Name:FRANKE, III
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 1:1820 SONOMA AVE
Mailing Address - Street 2:90 DOCTORS PARK DR. STE B
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-6616
Mailing Address - Country:US
Mailing Address - Phone:707-526-3303
Mailing Address - Fax:707-526-1385
Practice Address - Street 1:1820 SONOMA AVE
Practice Address - Street 2:90 DOCTORS PARK DR. STE B
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-6616
Practice Address - Country:US
Practice Address - Phone:707-526-3303
Practice Address - Fax:707-526-1385
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD26637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist