Doctor Name: | FRANK BRISENDINE |
NPI Number: | 1134333719 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.D. |
License Number: | 4 |
Business Practice Address: | Lakeside Denture Studio 6420 Hwy 93 South Lakeside, MT - 599220728 |
Business Phone Number: | 4068573711 |
Business Fax Number: | 4068573712 |
Mailing Address: | Po Box 728, LAKESIDE |
State: | MT |
Postal Code: | 599220728 |
Phone Number: | 4068573711 |
Fax Number: | 4068573712 |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 122400000X |
License Number: | 4 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Denturist |
Taxonomy Specialization: | |
Taxonomy Definition: |