Healthcare Provider Details

I. General information

NPI: 1841371622
Provider Name (Legal Business Name): KATHLEEN T FRANKLE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 BALTIMORE AVE SUITE 200
RIVERDALE MD
20737-1054
US

IV. Provider business mailing address

6200 BALTIMORE AVE SUITE 200
RIVERDALE MD
20737-1054
US

V. Phone/Fax

Practice location:
  • Phone: 301-864-5200
  • Fax: 301-864-5759
Mailing address:
  • Phone: 301-864-5200
  • Fax: 301-864-5759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number09345
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number04910
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: