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General NPI Number Information
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NPI Number | 1083821169
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Entity Type | Organization
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Legal Business Name | TERRENCE K FRANTAL DDS SC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7601 PERSHING BLVD
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City | KENOSHA
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State | WI
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Zip | 53142-4321
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Country | US
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Telephone | 262-694-1100
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Fax | 262-694-1103
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Provider Business Mailing Address
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Address Line | 7601 PERSHING BLVD
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City | KENOSHA
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State | WI
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Zip | 53142-4321
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Country | US
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Telephone | 262-694-1100
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Fax | 262-694-1103
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. PATRICIA SKINNER
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Credential |
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Telephone | 262-694-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5001388-015
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License Number State | WI
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