Provider Demographics
NPI:1215263231
Name:PODRASKY, FRANK PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:PAUL
Last Name:PODRASKY
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 1:501 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3567
Mailing Address - Country:US
Mailing Address - Phone:203-799-3311
Mailing Address - Fax:203-799-9937
Practice Address - Street 1:533 S BROAD ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-6661
Practice Address - Country:US
Practice Address - Phone:203-238-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT65221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice