Healthcare Provider Details

I. General information

NPI: 1861470924
Provider Name (Legal Business Name): FRANK ROBERT TRAFICANTE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31775 SR 20 STE A1
OAK HARBOR WA
98277-5104
US

IV. Provider business mailing address

14529 42ND DR SE
SNOHOMISH WA
98296-8414
US

V. Phone/Fax

Practice location:
  • Phone: 360-675-7573
  • Fax:
Mailing address:
  • Phone: 425-922-5369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE00010051
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14445
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number56536
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: