Healthcare Provider Details

I. General information

NPI: 1003157793
Provider Name (Legal Business Name): ERIC FRANK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 E BROAD ST STE 3
WESTFIELD NJ
07090-2279
US

IV. Provider business mailing address

522 E BROAD ST STE 3
WESTFIELD NJ
07090-2279
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-4949
  • Fax:
Mailing address:
  • Phone: 908-654-4949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02505300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: