Provider Demographics
NPI:1255357265
Name:FRANK, ROBERT JOEL (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOEL
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:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:VERGENNES
Mailing Address - State:VT
Mailing Address - Zip Code:05491
Mailing Address - Country:US
Mailing Address - Phone:802-877-6710
Mailing Address - Fax:
Practice Address - Street 1:23 SOUTH WATER STREET
Practice Address - Street 2:
Practice Address - City:VERGENNES
Practice Address - State:VT
Practice Address - Zip Code:05491
Practice Address - Country:US
Practice Address - Phone:802-877-2507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0160000511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0002407Medicaid