Healthcare Provider Details

I. General information

NPI: 1598882417
Provider Name (Legal Business Name): BRYAN J FRANTZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 ONEILL HWY
DUNMORE PA
18512-1719
US

IV. Provider business mailing address

1039 ONEILL HWY
DUNMORE PA
18512-1719
US

V. Phone/Fax

Practice location:
  • Phone: 570-344-3344
  • Fax: 570-344-3359
Mailing address:
  • Phone: 570-344-3344
  • Fax: 570-344-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDS-024759-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: