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General NPI Number Information
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NPI Number | 1982868634
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Entity Type | Organization
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Legal Business Name | STEVEN R. FREEMAN DDS PL
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 319 W TOWN PL STE 21
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3103
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Country | US
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Telephone | 904-940-3933
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Fax |
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Provider Business Mailing Address
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Address Line | 319 W TOWN PL STE 21
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3103
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Country | US
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Telephone | 904-940-3933
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | STEVEN RONALD FREEMAN
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Credential |
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Telephone | 904-940-3933
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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 | DN17155
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License Number State | FL
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