Provider Demographics
NPI:1447375423
Name:FRANK, BRADFORD L (DDS)
Entity type:Individual
Prefix:
First Name:BRADFORD
Middle Name:L
Last Name:FRANK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728D WESTMOOR CT SW STE D
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5754
Mailing Address - Country:US
Mailing Address - Phone:360-357-4505
Mailing Address - Fax:
Practice Address - Street 1:2728D WESTMOOR CT SW STE D
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5754
Practice Address - Country:US
Practice Address - Phone:360-357-4505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9915122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist