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General NPI Number Information
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NPI Number | 1972500908
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Entity Type | Organization
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Legal Business Name | ORTHODONTIC OPTIONS, LLC
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 3457 HENDRICKS AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5307
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Country | US
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Telephone | 904-398-6461
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Fax | 904-398-3177
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Provider Business Mailing Address
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Address Line | 3457 HENDRICKS AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5307
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Country | US
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Telephone | 904-398-6461
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Fax | 904-398-3177
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. CHARLES A. FRANK
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Credential | D.M.D.
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Telephone | 904-398-6461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN 0007489
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License Number State | FL
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