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NPI 1619197860

NPI 1619197860 : ROBERT LESLIE FRANKLIN JR. D.M.D. : ELIZABETHTOWN, KY

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General NPI Number Information
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    NPI Number           |    1619197860
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT LESLIE FRANKLIN JR. D.M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/30/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    611 W POPLAR ST 
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    City                 |    ELIZABETHTOWN
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    State                |    KY
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    Zip                  |    42701-2431
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    Country              |    US
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    Telephone            |    270-769-1622
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    Fax                  |    270-766-1044
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Provider Business Mailing Address
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    Address Line         |    611 W POPLAR ST 
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    City                 |    ELIZABETHTOWN
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    State                |    KY
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    Zip                  |    42701-2431
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    Country              |    US
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    Telephone            |    270-769-1622
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    Fax                  |    270-766-1044
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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        |    1223P0300X
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    Taxonomy Name        |    Periodontics
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    License Number       |    7556
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    License Number State |    KY
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