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General NPI Number Information
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NPI Number | 1457484933
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Entity Type | Individual
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Provider Name | JAY R FRIEDMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 8390 LORDS PL
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2926
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Country | US
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Telephone | 818-359-2076
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Fax |
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Provider Business Mailing Address
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Address Line | 3616 ALANDER CT
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City | CARLSBAD
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State | CA
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Zip | 92010-5519
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Country | US
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Telephone | 818-359-2076
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 33086
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 33086
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License Number State | CA
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