Provider Demographics
NPI:1437348752
Name:FRIEDMAN, GARY I
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:I
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 AIRPORT RD
Mailing Address - Street 2:1100
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2046
Mailing Address - Country:US
Mailing Address - Phone:317-852-1446
Mailing Address - Fax:
Practice Address - Street 1:20 AIRPORT RD
Practice Address - Street 2:1100
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2046
Practice Address - Country:US
Practice Address - Phone:317-852-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009280122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist