Provider Demographics
NPI:1013330042
Name:FRANKIEWICZ, THERESA (RDH)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:FRANKIEWICZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5950 SEMINOLE CENTRE CT
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-5023
Mailing Address - Country:US
Mailing Address - Phone:608-273-6500
Mailing Address - Fax:608-270-0891
Practice Address - Street 1:5950 SEMINOLE CENTRE CT
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5023
Practice Address - Country:US
Practice Address - Phone:608-273-6500
Practice Address - Fax:608-270-0891
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9779-016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist