Healthcare Provider Details

I. General information

NPI: 1922238427
Provider Name (Legal Business Name): ROBERT ANDREW FREEMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3944 ATLANTIC AVE
RALEIGH NC
27604-1700
US

IV. Provider business mailing address

9250 BRUCKHAUS APT 411
RALEIGH NC
27617-4406
US

V. Phone/Fax

Practice location:
  • Phone: 919-878-1810
  • Fax: 919-878-1840
Mailing address:
  • Phone: 919-259-3620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number8831
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number6606
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: