Provider Demographics
NPI:1417026477
Name:FRYDMAN, LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:FRYDMAN
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 1:75 CHESTNUT TER
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6620
Mailing Address - Country:US
Mailing Address - Phone:847-913-1080
Mailing Address - Fax:847-781-1551
Practice Address - Street 1:6326 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-2725
Practice Address - Country:US
Practice Address - Phone:773-778-7813
Practice Address - Fax:847-781-1551
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice