Provider Demographics
NPI:1326480559
Name:FREEDMAN, ISAAC JAY (DDS)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:JAY
Last Name:FREEDMAN
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 1:1260 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3128
Mailing Address - Country:US
Mailing Address - Phone:215-884-8289
Mailing Address - Fax:215-884-9085
Practice Address - Street 1:1260 EASTON RD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:PA
Practice Address - Zip Code:19001-3128
Practice Address - Country:US
Practice Address - Phone:215-884-8289
Practice Address - Fax:215-884-9085
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020755L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist