Provider Demographics
NPI:1700246899
Name:AGUEBOR, FRANKLYN OSAIGBOVO (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANKLYN
Middle Name:OSAIGBOVO
Last Name:AGUEBOR
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 1:818 RIVERFRONT DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-1968
Mailing Address - Country:US
Mailing Address - Phone:404-368-0668
Mailing Address - Fax:
Practice Address - Street 1:1775 GRAND CONCOURSE
Practice Address - Street 2:6TH FLOOR (DEPARTMENT OF DENTISTRY)
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-8202
Practice Address - Country:US
Practice Address - Phone:718-901-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program