1962483321 NPI number — FRANK M BONE DDS

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	BONE
Provider First Name	:	FRANK
Provider Middle Name	:	M
Provider Name Prefix Text	:
Provider Name Suffix Text	:
Provider Credential Text	:	DDS
Provider Gender Code	:	M

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NPI Number	:	1962483321
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/08/2007
NPI Deactivation Reason Code	:
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Provider First Line Business Mailing Address	:	1670 PUTNAM AVE
Provider Second Line Business Mailing Address	:	STE 1R
Provider Business Mailing Address City Name	:	RIDGEWOOD
Provider Business Mailing Address State Name	:	NY
Provider Business Mailing Address Postal Code	:	113853449
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	7183663700
Provider Business Mailing Address Fax Number	:	7183666999

Provider First Line Business Practice Location Address	:	1670 PUTNAM AVE
Provider Second Line Business Practice Location Address	:	STE 1R
Provider Business Practice Location Address City Name	:	RIDGEWOOD
Provider Business Practice Location Address State Name	:	NY
Provider Business Practice Location Address Postal Code	:	113853449
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	7183663700
Provider Business Practice Location Address Fax Number	:	7183666999
Provider Enumeration Date	:	11/10/2005

Authorized Official Last Name	:
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• Taxonomy code: 122300000X , with the licence number:  OA9255 1 , registered in the state of NY .

• Identifier: 02228031 , issued by the state of ( NY ) . This identifiers is of the category "".