Provider Demographics
NPI:1750400776
Name:FRANK, STEPHEN EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EUGENE
Last Name:FRANK
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 1:144 MAPLE STREET
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3264
Mailing Address - Country:US
Mailing Address - Phone:419-281-3395
Mailing Address - Fax:419-289-0971
Practice Address - Street 1:144 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3264
Practice Address - Country:US
Practice Address - Phone:419-281-3395
Practice Address - Fax:419-289-0971
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30015276122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0580410Medicaid