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NPI Code Detail

MEDICARE: DR. FRANK PETER BACCELLI DDS

MEDICARE: DR. FRANK PETER BACCELLI DDS
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
11223D0001XPublic Health Dentistry27583CA

General Provider Information

NPI Number : 1417999228
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANK PETER BACCELLI DDS
Provider Business Mailing Address
First Line : 15337 WARREN SHINGLE RD
Second Line :
City : BEALE AFB
State : CA
Zip : 95903-1905
Country : US
Telephone Number : 530-634-1710
Fax Number :
Provider Business Practice Location Address
First Line : 15337 WARREN SHINGLE RD
Second Line :
City : BEALE AFB
State : CA
Zip : 95903-1905
Country : US
Telephone Number : 530-634-1710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 07/08/2007

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Directions to “ DR. FRANK PETER BACCELLI DDS” Practice Location

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