Provider Demographics
NPI:1164987293
Name:FRIED, ZACHARY (DMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:FRIED
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 1:90 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4193
Mailing Address - Country:US
Mailing Address - Phone:781-935-8810
Mailing Address - Fax:
Practice Address - Street 1:90 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4193
Practice Address - Country:US
Practice Address - Phone:781-935-8810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-03
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18585721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice