MEDICARE: MRS. ALEESHA MICHELLE FREIMUTH DMD

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	DN15972	FL

General Provider Information

NPI Number	:	1528119203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEESHA MICHELLE FREIMUTH DMD

Provider Business Mailing Address
First Line	:	3101 SW 34TH AVE
Second Line	:	SUITE 600
City	:	OCALA
State	:	FL
Zip	:	34474-7447
Country	:	US
Telephone Number	:	352-861-2510
Fax Number	:	352-861-2498

Provider Business Practice Location Address
First Line	:	3101 SW 34TH AVE
Second Line	:	SUITE 600
City	:	OCALA
State	:	FL
Zip	:	34474-7447
Country	:	US
Telephone Number	:	352-861-2510
Fax Number	:	352-861-2498

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	09/03/2009

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