Provider Demographics
NPI:1003136086
Name:FREEDENBERG, JOEL HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:HOWARD
Last Name:FREEDENBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17706 GLOBE THEATRE DR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1675
Mailing Address - Country:US
Mailing Address - Phone:301-570-5498
Mailing Address - Fax:301-570-1716
Practice Address - Street 1:5005 SIGNAL BELL LN
Practice Address - Street 2:#101
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-2606
Practice Address - Country:US
Practice Address - Phone:443-535-8940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD79731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice