Provider Demographics
NPI:1659425924
Name:FRIED, RONALD MARTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MARTIN
Last Name:FRIED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4707
Mailing Address - Country:US
Mailing Address - Phone:617-232-8222
Mailing Address - Fax:
Practice Address - Street 1:1443 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4707
Practice Address - Country:US
Practice Address - Phone:617-232-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156981223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics