Provider Demographics
NPI:1629109566
Name:FREIDANK, CHRISTIAN WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:WILLIAM
Last Name:FREIDANK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9613 CHAMPION CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4402
Mailing Address - Country:US
Mailing Address - Phone:703-368-4713
Mailing Address - Fax:703-393-1844
Practice Address - Street 1:9613 CHAMPION CT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4402
Practice Address - Country:US
Practice Address - Phone:703-368-4713
Practice Address - Fax:703-393-1844
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010078621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice