Provider Demographics
NPI:1073080396
Name:SAMAN M FREEDMAN DMD LLC
Entity Type:Organization
Organization Name:SAMAN M FREEDMAN DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:BILLER
Authorized Official - Phone:813-679-5276
Mailing Address - Street 1:1333 3RD AVE S STE 401
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6535
Mailing Address - Country:US
Mailing Address - Phone:813-679-5276
Mailing Address - Fax:813-433-5481
Practice Address - Street 1:1333 3RD AVE S STE 401
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6535
Practice Address - Country:US
Practice Address - Phone:813-679-5276
Practice Address - Fax:813-433-5481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1629269923OtherNPI