Provider Demographics
NPI:1942294152
Name:ALLARA, FRANK WINFRED JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:WINFRED
Last Name:ALLARA
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:359TH MEDICAL GROUP
Mailing Address - Street 2:221 THIRD STREET WEST; BUILDING 1040
Mailing Address - City:JOINT BASE SAN ANTONIO-RANDOLPH
Mailing Address - State:TX
Mailing Address - Zip Code:78150
Mailing Address - Country:US
Mailing Address - Phone:210-395-9967
Mailing Address - Fax:
Practice Address - Street 1:359TH MEDICAL GROUP
Practice Address - Street 2:221 THIRD STREET WEST; BUILDING 1040
Practice Address - City:JOINT BASE SAN ANTONIO-RANDOLPH
Practice Address - State:TX
Practice Address - Zip Code:78150
Practice Address - Country:US
Practice Address - Phone:210-395-9967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY62571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6257OtherDENTAL LICENSE