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DR. VINCENT JOHN FRATTALI D. D. S.
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1699751115
Individual Registrant:DR. VINCENT JOHN FRATTALI D. D. S.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
6203 AGENCY LOOP RD WELLPINIT, WA 99040-0357 US
Tel: 509-258-4517 Fax: 509-258-4456
Tel: 509-258-4517 Fax: 509-258-4456
Contact information for business:
PO BOX 357 WELLPINIT, WA 99040-0357 US
Tel: 509-258-4517 Fax: 509-258-4456
Tel: 509-258-4517 Fax: 509-258-4456
Registration Information:
NPI: 1699751115
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | MD | 07883 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
