Provider Demographics
NPI:1487784476
Name:LATORRACA, FRANK DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DANIEL
Last Name:LATORRACA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-1606
Mailing Address - Country:US
Mailing Address - Phone:973-675-0653
Mailing Address - Fax:973-676-6268
Practice Address - Street 1:34 HIGH ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-1606
Practice Address - Country:US
Practice Address - Phone:973-675-0653
Practice Address - Fax:973-676-6268
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD121471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice