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General NPI Number Information
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NPI Number | 1760633044
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Entity Type | Individual
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Provider Name | ELLEN K. FRIEDMAN DMD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 23300 CHAGRIN BLVD G-10
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City | BEACHWOOD
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State | OH
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Zip | 44122-5557
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Country | US
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Telephone | 216-464-1180
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Fax | 216-464-3707
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Provider Business Mailing Address
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Address Line | 23300 CHAGRIN BLVD G-10
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City | BEACHWOOD
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State | OH
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Zip | 44122-5557
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Country | US
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Telephone | 216-464-1180
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Fax | 216-464-3707
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30-022817
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License Number State | OH
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