Provider Demographics
NPI:1598958951
Name:DE FREITAS, ROSEMARY C (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:C
Last Name:DE FREITAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3515
Mailing Address - Country:US
Mailing Address - Phone:732-840-1199
Mailing Address - Fax:732-785-0918
Practice Address - Street 1:15 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3515
Practice Address - Country:US
Practice Address - Phone:732-840-1199
Practice Address - Fax:732-785-0918
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02327800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist