Provider Demographics
NPI:1053301846
Name:FREEMAN, PAUL S JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:FREEMAN
Suffix:JR
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 1:2403 JOHN F KENNEDY BLVD
Mailing Address - Street 2:P.O BOX 2403
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1909
Mailing Address - Country:US
Mailing Address - Phone:201-332-1664
Mailing Address - Fax:201-332-8808
Practice Address - Street 1:2403 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1909
Practice Address - Country:US
Practice Address - Phone:201-332-1664
Practice Address - Fax:201-332-8808
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ80821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice