Provider Demographics
NPI:1912124926
Name:FRANK A DAHLSTROM,DMD,PC.
Entity Type:Organization
Organization Name:FRANK A DAHLSTROM,DMD,PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ALDEN
Authorized Official - Last Name:DAHLSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-385-3136
Mailing Address - Street 1:811 MAIN ST
Mailing Address - Street 2:P O BOX 985
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-0985
Mailing Address - Country:US
Mailing Address - Phone:508-385-3136
Mailing Address - Fax:508-385-3137
Practice Address - Street 1:811 MAIN ST
Practice Address - Street 2:
Practice Address - City:DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02638-0985
Practice Address - Country:US
Practice Address - Phone:508-385-3136
Practice Address - Fax:508-385-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty