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General NPI Number Information
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NPI Number | 1053549568
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Entity Type | Organization
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Legal Business Name | RANDALL K. FREEMAN, DDS
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 54 WEST MAIN STREET
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City | BLOOMFIELD
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State | NY
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Zip | 14469-9231
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Country | US
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Telephone | 585-657-6909
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Fax | 585-657-7016
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Provider Business Mailing Address
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Address Line | 54 WEST MAIN STREET PO BOX 369
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City | BLOOMFIELD
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State | NY
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Zip | 14469-9231
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Country | US
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Telephone | 585-657-6909
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Fax | 585-657-7016
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Authorized Official
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Title or Position | OFFICE COORDINATOR
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Name | KATHY L DAILEY
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Credential |
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Telephone | 585-657-6909
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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 |
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License Number State |
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