Provider Demographics
NPI:1659538312
Name:FREIMAUER, RICHARD MELVIN (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:MELVIN
Last Name:FREIMAUER
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 1:410 STATE ROUTE 10
Mailing Address - Street 2:
Mailing Address - City:LEDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07852-9658
Mailing Address - Country:US
Mailing Address - Phone:973-584-3773
Mailing Address - Fax:973-584-0994
Practice Address - Street 1:410 STATE ROUTE 10
Practice Address - Street 2:
Practice Address - City:LEDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07852-9658
Practice Address - Country:US
Practice Address - Phone:973-584-3773
Practice Address - Fax:973-584-0994
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22-D100921300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist