Provider Demographics
NPI:1750582524
Name:DALENA, FRANK (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:DALENA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1438
Mailing Address - Country:US
Mailing Address - Phone:203-261-9646
Mailing Address - Fax:203-445-0831
Practice Address - Street 1:2268 MAIN ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-5999
Practice Address - Country:US
Practice Address - Phone:203-375-9925
Practice Address - Fax:203-380-2164
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist