Provider Demographics
NPI:1275657744
Name:FRIEDMAN, PAUL R (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:FRIEDMAN
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 1:103 SUDBROOK LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4121
Mailing Address - Country:US
Mailing Address - Phone:410-486-1914
Mailing Address - Fax:410-653-1794
Practice Address - Street 1:103 SUDBROOK LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-4121
Practice Address - Country:US
Practice Address - Phone:410-486-1914
Practice Address - Fax:410-653-1794
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics