Provider Demographics
NPI:1114957586
Name:FREYERMUTH, CHRISTOPHER JON (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JON
Last Name:FREYERMUTH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CLIFFORD RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2110
Mailing Address - Country:US
Mailing Address - Phone:508-746-6136
Mailing Address - Fax:508-746-7755
Practice Address - Street 1:92 SANDWICH ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3334
Practice Address - Country:US
Practice Address - Phone:508-746-7755
Practice Address - Fax:508-746-7755
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA167851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice