Provider Demographics
NPI:1144218173
Name:FREISCHEL, MICHAEL ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:FREISCHEL
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 1:350 SAINT PETER ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1514
Mailing Address - Country:US
Mailing Address - Phone:651-292-8457
Mailing Address - Fax:651-292-0313
Practice Address - Street 1:350 SAINT PETER ST
Practice Address - Street 2:SUITE 260
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1514
Practice Address - Country:US
Practice Address - Phone:651-292-8457
Practice Address - Fax:651-292-0313
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist