Provider Demographics
NPI:1891130944
Name:FRANK, PHILLIP S
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:S
Last Name:FRANK
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:PHILLIP
Other - Middle Name:S
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:715 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4405
Mailing Address - Country:US
Mailing Address - Phone:718-963-3400
Mailing Address - Fax:718-963-3401
Practice Address - Street 1:715 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4405
Practice Address - Country:US
Practice Address - Phone:718-963-3400
Practice Address - Fax:718-963-3401
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist