Provider Demographics
NPI:1609893171
Name:FRIEDL, MICHELE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MARIE
Last Name:FRIEDL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8168 BRIAR RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:303-663-8193
Mailing Address - Fax:
Practice Address - Street 1:5959 S UNIVERSITY
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80121
Practice Address - Country:US
Practice Address - Phone:303-795-7674
Practice Address - Fax:303-794-8947
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO80471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice