MEDICARE: DR. FRANCES PAK DMD

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	122300000X	Dentist	12581	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932170685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCES PAK DMD

Provider Business Mailing Address
First Line	:	10326A BALTIMORE NATIONAL PIKE
Second Line	:	STE A
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2128
Country	:	US
Telephone Number	:	410-461-1166
Fax Number	:	410-461-1470

Provider Business Practice Location Address
First Line	:	10326A BALTIMORE NATIONAL PIKE
Second Line	:	STE A
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2128
Country	:	US
Telephone Number	:	410-461-1166
Fax Number	:	410-461-1470

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	10/09/2008

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Directions to “ DR. FRANCES PAK DMD” Practice Location

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