MEDICARE: DR. THOMAS LEE FRANK D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12010858A	IN

General Provider Information

NPI Number	:	1023187713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS LEE FRANK D.D.S.

Provider Business Mailing Address
First Line	:	295 N MILL ST
Second Line	:
City	:	PLAINFIELD
State	:	IN
Zip	:	46168-1141
Country	:	US
Telephone Number	:	317-837-7762
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 E 82ND ST # A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-1500
Country	:	US
Telephone Number	:	317-577-5758
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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