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General NPI Number Information
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NPI Number | 1033180369
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Entity Type | Individual
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Provider Name | DR. RICK FREEDMAN
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 HALSEY AVE
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City | MARIETTA
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State | GA
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Zip | 30060-5099
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Country | US
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Telephone | 678-655-4314
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Fax |
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Provider Business Mailing Address
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Address Line | 5553 SALUDA CT NW
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City | ACWORTH
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State | GA
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Zip | 30101-8094
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Country | US
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Telephone | 678-655-4314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS027774L
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License Number State | PA
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