Provider Demographics
NPI:1942325741
Name:SHORT, FRANKLIN PIERCE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:PIERCE
Last Name:SHORT
Suffix:JR
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:RT. 10, COOK PARKWAY
Mailing Address - Street 2:
Mailing Address - City:OCEANA
Mailing Address - State:WV
Mailing Address - Zip Code:24870-1330
Mailing Address - Country:US
Mailing Address - Phone:304-682-8287
Mailing Address - Fax:304-682-8388
Practice Address - Street 1:RT. 10, COOK PARKWAY
Practice Address - Street 2:
Practice Address - City:OCEANA
Practice Address - State:WV
Practice Address - Zip Code:24870-1330
Practice Address - Country:US
Practice Address - Phone:304-682-8287
Practice Address - Fax:304-682-8388
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice