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General NPI Number Information
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NPI Number | 1124376397
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Entity Type | Individual
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Provider Name | ANGELIQUE RENEE FREKING DDS
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Gender | Female
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Dates
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Enumeration Date | 08/20/2012
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 15 E 12TH ST APT 3
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City | NEW YORK
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State | NY
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Zip | 10003-4436
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Country | US
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Telephone | 720-273-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 30 WALL STREET #720
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City | NEW YORK
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State | NY
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Zip | 10005
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Country | US
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Telephone | 212-514-5514
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Fax | 212-514-8510
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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 | 056261
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 056261
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License Number State | NY
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