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NPI Code Detail

MEDICARE: FRONTIER FAMILY DENTAL INC

MEDICARE: FRONTIER FAMILY DENTAL INC
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1649500539
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRONTIER FAMILY DENTAL INC
Provider Business Mailing Address
First Line : 1840 E CALVADA BLVD
Second Line : SUITE 14
City : PAHRUMP
State : NV
Zip : 89048-5866
Country : US
Telephone Number : 775-727-6006
Fax Number : 775-727-6001
Provider Business Practice Location Address
First Line : 1840 E CALVADA BLVD
Second Line : SUITE 14
City : PAHRUMP
State : NV
Zip : 89048-5866
Country : US
Telephone Number : 775-727-6006
Fax Number : 775-727-6001
Authorized Official
Title or Position : PRESIDENT
Name : DR. PAMELA J PATTEN
Credential : DDS
Telephone Number : 775-727-6006
Provider Enumeration Date : 12/28/2009
Last Update Date : 12/28/2009

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Directions to “FRONTIER FAMILY DENTAL INC ” Practice Location

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