Healthcare Provider Details

I. General information

NPI: 1376918474
Provider Name (Legal Business Name): BENJAMIN ISAIAH FRIBERG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8115 MARKET ST STE 204
WILMINGTON NC
28411-8430
US

IV. Provider business mailing address

8115 MARKET ST STE 204
WILMINGTON NC
28411-8430
US

V. Phone/Fax

Practice location:
  • Phone: 910-240-4797
  • Fax:
Mailing address:
  • Phone: 910-240-4797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD10359
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10315
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: