Provider Demographics
NPI:1811329840
Name:FRATT DENTAL CORPORATION
Entity type:Organization
Organization Name:FRATT DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:866-898-1355
Mailing Address - Street 1:1601 W 17TH ST STE G
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-3340
Mailing Address - Country:US
Mailing Address - Phone:714-567-9255
Mailing Address - Fax:714-543-1998
Practice Address - Street 1:1601 W 17TH ST STE G
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3340
Practice Address - Country:US
Practice Address - Phone:714-567-9255
Practice Address - Fax:714-543-9182
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRATT DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty