MEDICARE: DR. FRANK ARTHUR DRISCOLL DDS,MSD

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	1223P0221X	Pediatric Dentistry	3441	NE

General Provider Information

NPI Number	:	1891917738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK ARTHUR DRISCOLL DDS,MSD

Provider Business Mailing Address
First Line	:	2514 S. 119TH STREET
Second Line	:	204
City	:	OMAHA
State	:	NE
Zip	:	68144-2869
Country	:	US
Telephone Number	:	402-330-5913
Fax Number	:	402-333-3190

Provider Business Practice Location Address
First Line	:	2514 S. 119TH STREET
Second Line	:	204
City	:	OMAHA
State	:	NE
Zip	:	68144-2869
Country	:	US
Telephone Number	:	402-330-5913
Fax Number	:	402-333-3190

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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