Provider Demographics
NPI:1861774788
Name:FRANK L MAMS
Entity type:Organization
Organization Name:FRANK L MAMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:MAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-636-5800
Mailing Address - Street 1:600 S RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-5702
Mailing Address - Country:US
Mailing Address - Phone:304-636-5800
Mailing Address - Fax:304-636-0971
Practice Address - Street 1:600 S RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-5702
Practice Address - Country:US
Practice Address - Phone:304-636-5800
Practice Address - Fax:304-636-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6693700001Medicare NSC