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General NPI Number Information
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NPI Number | 1114147576
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Entity Type | Organization
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Legal Business Name | FRANK GONTARSKI DDS
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4363 HAZEL AVE #6
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City | FAIR OAKS
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State | CA
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Zip | 95628
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Country | US
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Telephone | 916-962-3500
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Fax | 916-962-3592
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Provider Business Mailing Address
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Address Line | 4363 HAZEL AVE #6
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City | FAIR OAKS
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State | CA
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Zip | 95628
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Country | US
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Telephone | 916-962-3500
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Fax | 916-962-3592
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Authorized Official
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Title or Position | OWNER SOLE PROPRIETOR
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Name | DR. FRANK GONTARSKI
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Credential | DDS
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Telephone | 916-962-3500
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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 | 30217
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License Number State | CA
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