MEDICARE: DR ANDREW D FRIEDMAN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	2661	ME

General Provider Information

NPI Number	:	1790976553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ANDREW D FRIEDMAN DMD

Provider Business Mailing Address
First Line	:	21 OLD POINT AVE
Second Line	:
City	:	MADISON
State	:	ME
Zip	:	04950-1114
Country	:	US
Telephone Number	:	207-696-4681
Fax Number	:	207-696-5345

Provider Business Practice Location Address
First Line	:	21 OLD POINT AVE
Second Line	:
City	:	MADISON
State	:	ME
Zip	:	04950-1114
Country	:	US
Telephone Number	:	207-696-4681
Fax Number	:	207-696-5345

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. ANDREW DONALD FRIEDMAN
Credential	:	D.M.D.
Telephone Number	:	207-696-4681

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	08/07/2007

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