MEDICARE: DR. DANIEL DERRICK 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	1223P0221X	Pediatric Dentistry	DD7767	TN

General Provider Information

NPI Number	:	1922197250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL DERRICK FREEMAN DDS

Provider Business Mailing Address
First Line	:	2567 APPLING RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38133-5099
Country	:	US
Telephone Number	:	901-383-7337
Fax Number	:	301-507-1390

Provider Business Practice Location Address
First Line	:	2567 APPLING RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38133-5099
Country	:	US
Telephone Number	:	901-383-7337
Fax Number	:	301-507-1390

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	04/17/2014

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