Provider Demographics
NPI:1649667486
Name:FRANK A. FINAZZO, DDS, INC.
Entity type:Organization
Organization Name:FRANK A. FINAZZO, DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FINAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-822-3003
Mailing Address - Street 1:17113 ARROW BLVD
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3948
Mailing Address - Country:US
Mailing Address - Phone:909-822-3003
Mailing Address - Fax:909-822-2757
Practice Address - Street 1:17113 ARROW BLVD
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3948
Practice Address - Country:US
Practice Address - Phone:909-822-3003
Practice Address - Fax:909-822-2757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445001223E0200X
1223S0112X
CA38278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty