Provider Demographics
NPI:1255433470
Name:FRANKSTON DENTAL OFFICE
Entity type:Organization
Organization Name:FRANKSTON DENTAL OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER HYGIENIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:T
Authorized Official - Last Name:LUMMUS
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:903-876-3600
Mailing Address - Street 1:PO BOX 700
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763
Mailing Address - Country:US
Mailing Address - Phone:903-876-3600
Mailing Address - Fax:903-876-2175
Practice Address - Street 1:400 N FRANKSTON HWY
Practice Address - Street 2:
Practice Address - City:FRANKSTON
Practice Address - State:TX
Practice Address - Zip Code:75763
Practice Address - Country:US
Practice Address - Phone:903-876-3600
Practice Address - Fax:903-876-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty