MEDICARE: DR. GREGORY E. FREEMAN 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
1	1223G0001X	General Practice Dentistry	9502	GA

General Provider Information

NPI Number	:	1275557290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY E. FREEMAN DDS

Provider Business Mailing Address
First Line	:	100 COLLEGE ST
Second Line	:
City	:	HOGANSVILLE
State	:	GA
Zip	:	30230-1114
Country	:	US
Telephone Number	:	706-637-6125
Fax Number	:	706-637-6129

Provider Business Practice Location Address
First Line	:	100 COLLEGE ST
Second Line	:
City	:	HOGANSVILLE
State	:	GA
Zip	:	30230-1114
Country	:	US
Telephone Number	:	706-637-6125
Fax Number	:	706-637-6129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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