Provider Demographics
NPI:1033180369
Name:FREEDMAN, RICK
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5553 SALUDA CT NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8094
Mailing Address - Country:US
Mailing Address - Phone:678-655-4314
Mailing Address - Fax:
Practice Address - Street 1:1000 HALSEY AVE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-5099
Practice Address - Country:US
Practice Address - Phone:678-655-4314
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027774L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist