Provider Demographics
NPI:1952410649
Name:FRANTZ, BERNARD EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:EDWARD
Last Name:FRANTZ
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 1:189 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5400
Mailing Address - Country:US
Mailing Address - Phone:570-288-6220
Mailing Address - Fax:570-288-6253
Practice Address - Street 1:189 MARKET ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5400
Practice Address - Country:US
Practice Address - Phone:570-288-6220
Practice Address - Fax:570-288-6253
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028565L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BF3787299OtherDFA #
PADS0285652OtherPA STATE
BF3787299OtherDFA #