Provider Demographics
NPI:1275557290
Name:FREEMAN, GREGORY E (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:E
Last Name:FREEMAN
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 1:100 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:HOGANSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30230-1114
Mailing Address - Country:US
Mailing Address - Phone:706-637-6125
Mailing Address - Fax:706-637-6129
Practice Address - Street 1:100 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HOGANSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30230-1114
Practice Address - Country:US
Practice Address - Phone:706-637-6125
Practice Address - Fax:706-637-6129
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice