Healthcare Provider Details

I. General information

NPI: 1801625157
Provider Name (Legal Business Name): TODD FRANKLIN DENTAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 W TOKAY ST
LODI CA
95240-3810
US

IV. Provider business mailing address

1208 W TOKAY ST
LODI CA
95240-3810
US

V. Phone/Fax

Practice location:
  • Phone: 209-334-4370
  • Fax:
Mailing address:
  • Phone: 209-334-4370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. TODD FRANKLIN
Title or Position: PRESIDENT
Credential: DDS
Phone: 209-334-4370