Provider Demographics
NPI:1053439224
Name:PLANZ, FREDERICK FRAZIER (DMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:FRAZIER
Last Name:PLANZ
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:PO BOX 125
Mailing Address - Street 2:29 PLANZ LANE
Mailing Address - City:BRIDGEWATER
Mailing Address - State:CT
Mailing Address - Zip Code:06752
Mailing Address - Country:US
Mailing Address - Phone:860-355-0770
Mailing Address - Fax:
Practice Address - Street 1:29 PLANZ LANE
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:CT
Practice Address - Zip Code:06752
Practice Address - Country:US
Practice Address - Phone:860-355-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT47371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice