Provider Demographics
NPI:1235206020
Name:FREE, JAMES DOYLE (DR)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOYLE
Last Name:FREE
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 S 58TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516
Mailing Address - Country:US
Mailing Address - Phone:402-420-6565
Mailing Address - Fax:402-420-6566
Practice Address - Street 1:6201 S 58TH ST
Practice Address - Street 2:STE D
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-420-6565
Practice Address - Fax:402-420-6566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist