Provider Demographics
NPI:1295137461
Name:FRAME FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:FRAME FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FRAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-576-0332
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:IN
Mailing Address - Zip Code:47355-0035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:IN
Practice Address - Zip Code:47355
Practice Address - Country:US
Practice Address - Phone:765-874-2571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012158A261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental