Provider Demographics
NPI:1528638236
Name:FRONCZAK, STEVEN (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:FRONCZAK
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 1:15816 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2345
Mailing Address - Country:US
Mailing Address - Phone:858-602-2968
Mailing Address - Fax:
Practice Address - Street 1:1455 G ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-7434
Practice Address - Country:US
Practice Address - Phone:619-324-4981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1063241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice