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NPI Code Detail

MEDICARE: DR. PAUL S FREEMAN JR. DDS

MEDICARE: DR. PAUL S FREEMAN JR. DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry8082NJ

General Provider Information

NPI Number : 1053301846
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL S FREEMAN JR. DDS
Provider Business Mailing Address
First Line : 2403 JOHN F KENNEDY BLVD
Second Line : P.O BOX 2403
City : JERSEY CITY
State : NJ
Zip : 07304-1909
Country : US
Telephone Number : 201-332-1664
Fax Number : 201-332-8808
Provider Business Practice Location Address
First Line : 2403 JOHN F KENNEDY BLVD
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07304-1909
Country : US
Telephone Number : 201-332-1664
Fax Number : 201-332-8808
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 07/09/2007

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