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NPI 1225296445

NPI 1225296445 : FRANK JOHN DAHL JR. DDS : WHITE PLAINS, NY

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General NPI Number Information
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    NPI Number           |    1225296445
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    Entity Type          |    Individual 
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    Provider Name        |    FRANK JOHN DAHL JR. DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/23/2008
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    Last Update Date     |    05/23/2008
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Provider Practice Location Address
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    Address Line         |    95 NORTH BROADWAY A2-1 
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    City                 |    WHITE PLAINS
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    State                |    NY
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    Zip                  |    10603-4811
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    Country              |    US
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    Telephone            |    914-681-0343
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    Fax                  |    914-948-2660
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Provider Business Mailing Address
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    Address Line         |    95 NORTH BROADWAY A2-1 
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    City                 |    WHITE PLAINS
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    State                |    NY
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    Zip                  |    10603-4811
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    Country              |    US
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    Telephone            |    914-681-0343
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    Fax                  |    914-948-2660
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    036024
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    License Number State |    NY
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