Provider Demographics
NPI:1154920437
Name:FRANTZ, DALLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:DALLAS
Middle Name:
Last Name:FRANTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10205 NE 106TH CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-4244
Mailing Address - Country:US
Mailing Address - Phone:360-624-8578
Mailing Address - Fax:
Practice Address - Street 1:3208 NE 54TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-1952
Practice Address - Country:US
Practice Address - Phone:360-693-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61024925122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist