Provider Demographics
NPI:1750783338
Name:FRANK C. SPARACINO DDS MHS PC
Entity type:Organization
Organization Name:FRANK C. SPARACINO DDS MHS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SPARACINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MHS
Authorized Official - Phone:843-553-5355
Mailing Address - Street 1:8800 NORTHPARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9226
Mailing Address - Country:US
Mailing Address - Phone:843-553-5355
Mailing Address - Fax:843-553-5205
Practice Address - Street 1:8800 NORTHPARK BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9226
Practice Address - Country:US
Practice Address - Phone:843-553-5355
Practice Address - Fax:843-553-5205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FANK C. SPARACINO DDS MHS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16336231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty