Provider Demographics
NPI:1376664979
Name:FRIEDMAN, S. DOVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:S.
Middle Name:DOVID
Last Name:FRIEDMAN
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 1:201 MEETING HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1211
Mailing Address - Country:US
Mailing Address - Phone:610-667-1984
Mailing Address - Fax:610-667-2438
Practice Address - Street 1:201 MEETING HOUSE LN
Practice Address - Street 2:
Practice Address - City:MERION STATION
Practice Address - State:PA
Practice Address - Zip Code:19066-1211
Practice Address - Country:US
Practice Address - Phone:610-667-1984
Practice Address - Fax:610-667-2438
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2012-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0306701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics