Healthcare Provider Details

I. General information

NPI: 1639478399
Provider Name (Legal Business Name): FRANK A. SHARP DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 E BRADFORD PKWY
SPRINGFIELD MO
65804-6565
US

IV. Provider business mailing address

1524 E BRADFORD PKWY
SPRINGFIELD MO
65804-6565
US

V. Phone/Fax

Practice location:
  • Phone: 417-888-3030
  • Fax: 417-888-3029
Mailing address:
  • Phone: 417-888-3030
  • Fax: 417-888-3029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number015539
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: