Provider Demographics
NPI:1275664922
Name:FREED, BARBARA WALD (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:WALD
Last Name:FREED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2243
Mailing Address - Country:US
Mailing Address - Phone:413-549-3608
Mailing Address - Fax:413-549-5206
Practice Address - Street 1:28 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2243
Practice Address - Country:US
Practice Address - Phone:413-549-3608
Practice Address - Fax:413-549-5206
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice