Provider Demographics
NPI:1720201973
Name:FRANKLIN CORNER DENTAL ASSOCIATES PA
Entity Type:Organization
Organization Name:FRANKLIN CORNER DENTAL ASSOCIATES PA
Other - Org Name:FRANKLIN CORNER DENTAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:TREATMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DESIRAE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SPOTO
Authorized Official - Suffix:
Authorized Official - Credentials:RDA
Authorized Official - Phone:609-896-0100
Mailing Address - Street 1:96 FRANKLIN CORNER RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2102
Mailing Address - Country:US
Mailing Address - Phone:609-896-0100
Mailing Address - Fax:
Practice Address - Street 1:96 FRANKLIN CORNER RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08648-2102
Practice Address - Country:US
Practice Address - Phone:609-896-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ15498NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty