Healthcare Provider Details

I. General information

NPI: 1720183932
Provider Name (Legal Business Name): CHRISTOPHER SCOTT FREEMAN D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W SUNRISE BLVD SUITE B-3
PLANTATION FL
33322-5426
US

IV. Provider business mailing address

8200 W SUNRISE BLVD SUITE B-3
PLANTATION FL
33322-5426
US

V. Phone/Fax

Practice location:
  • Phone: 954-474-4436
  • Fax: 954-474-4674
Mailing address:
  • Phone: 954-474-4436
  • Fax: 954-474-4674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN15971
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: