Provider Demographics
NPI:1831306646
Name:FRATT DENTAL CORPORATION
Entity Type:Organization
Organization Name:FRATT DENTAL CORPORATION
Other - Org Name:LAWNDALE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-428-1200
Mailing Address - Street 1:16128 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2931
Mailing Address - Country:US
Mailing Address - Phone:310-370-4511
Mailing Address - Fax:
Practice Address - Street 1:16128 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2931
Practice Address - Country:US
Practice Address - Phone:310-370-4511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty