Provider Demographics
NPI:1609155175
Name:YAEL FRYDMAN DMD PC
Entity Type:Organization
Organization Name:YAEL FRYDMAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-803-5498
Mailing Address - Street 1:141 DORCHESTER AVE UNIT 115
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-1832
Mailing Address - Country:US
Mailing Address - Phone:617-803-5498
Mailing Address - Fax:
Practice Address - Street 1:800 BOYLSTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-8001
Practice Address - Country:US
Practice Address - Phone:617-259-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252602122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty