Provider Demographics
NPI:1619545779
Name:YAEL FRYDMAN DMD PC
Entity Type:Organization
Organization Name:YAEL FRYDMAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:DR
Authorized Official - First Name:YAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-803-5498
Mailing Address - Street 1:46 FARNSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210-1211
Mailing Address - Country:US
Mailing Address - Phone:617-259-1100
Mailing Address - Fax:
Practice Address - Street 1:46 FARNSWORTH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210-1211
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:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty