Provider Demographics
NPI:1306367792
Name:FREER, ZACHARY LEO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:LEO
Last Name:FREER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 W ALDER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-2326
Mailing Address - Country:US
Mailing Address - Phone:310-528-3022
Mailing Address - Fax:
Practice Address - Street 1:273 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2728
Practice Address - Country:US
Practice Address - Phone:619-426-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1013841223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics