MEDICARE: DR. FRANTZ F BACKER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	048939	NY

General Provider Information

NPI Number	:	1346286291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANTZ F BACKER DDS

Provider Business Mailing Address
First Line	:	974 E 101ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-2618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	189 MONTAGUE ST
Second Line	:	SUITE 800 A
City	:	BROOKLYN
State	:	NY
Zip	:	11201-3610
Country	:	US
Telephone Number	:	718-797-0267
Fax Number	:	718-783-3855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	07/08/2007

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