Provider Demographics
NPI:1598889404
Name:FRIEDBERG, BEVERLY HURLEY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:HURLEY
Last Name:FRIEDBERG
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5512
Mailing Address - Country:US
Mailing Address - Phone:410-392-9258
Mailing Address - Fax:410-398-9190
Practice Address - Street 1:201 NORTH ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5512
Practice Address - Country:US
Practice Address - Phone:410-392-9258
Practice Address - Fax:410-398-9190
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD88211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics