Provider Demographics
NPI:1962483321
Name:BONE, FRANK M (DDS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:M
Last Name:BONE
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 1:1670 PUTNAM AVE
Mailing Address - Street 2:STE 1R
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3449
Mailing Address - Country:US
Mailing Address - Phone:718-366-3700
Mailing Address - Fax:718-366-6999
Practice Address - Street 1:1670 PUTNAM AVE
Practice Address - Street 2:STE 1R
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3449
Practice Address - Country:US
Practice Address - Phone:718-366-3700
Practice Address - Fax:718-366-6999
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYOA9255 1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02228031Medicaid