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General NPI Number Information
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NPI Number | 1497029052
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Entity Type | Organization
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Legal Business Name | FRANDSEN FAMILY DENTISTRY P.C.
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 165 S OREM BLVD
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City | OREM
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State | UT
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Zip | 84058-3006
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Country | US
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Telephone | 801-224-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 165 S OREM BLVD
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City | OREM
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State | UT
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Zip | 84058-3006
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Country | US
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Telephone | 801-224-7900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN LLOYD FRANDSEN
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Credential | D.D.S.
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Telephone | 801-699-9047
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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 | 51251339921
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License Number State | UT
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