Provider Demographics
NPI:1275739112
Name:FREEMAN, DAVID CLARK (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLARK
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 BLOOMFIELD LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5054
Mailing Address - Country:US
Mailing Address - Phone:559-325-3300
Mailing Address - Fax:
Practice Address - Street 1:2127 HERNDON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6303
Practice Address - Country:US
Practice Address - Phone:559-325-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA529831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics