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General NPI Number Information
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NPI Number | 1376691097
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Entity Type | Individual
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Provider Name | FRANK C GRAMMER DDS, PHD
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 1708 E JOYCE BLVD SUITE 2
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5252
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Country | US
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Telephone | 479-582-3002
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Fax | 479-582-2840
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Provider Business Mailing Address
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Address Line | PO BOX 4185
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City | FAYETTEVILLE
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State | AR
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Zip | 72702-4185
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Country | US
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Telephone | 479-717-1171
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Fax | 479-725-2395
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 1931
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 1931
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License Number State | AR
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