Provider Demographics
NPI:1336223809
Name:BENNEYAN, FRANK MELCON (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MELCON
Last Name:BENNEYAN
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 1:5446 N PALM AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1945
Mailing Address - Country:US
Mailing Address - Phone:559-432-3220
Mailing Address - Fax:559-432-1752
Practice Address - Street 1:5446 N PALM AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1945
Practice Address - Country:US
Practice Address - Phone:559-432-3220
Practice Address - Fax:559-432-1752
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice