Provider Demographics
NPI:1801080965
Name:DE CZITO, FRANK I (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:I
Last Name:DE CZITO
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 1:2901 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4901
Mailing Address - Country:US
Mailing Address - Phone:310-829-2482
Mailing Address - Fax:310-829-5231
Practice Address - Street 1:2901 WILSHIRE BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4901
Practice Address - Country:US
Practice Address - Phone:310-829-2482
Practice Address - Fax:310-829-5231
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist