Provider Demographics
NPI:1669478061
Name:FRIEDMAN, DANIEL STEWART (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEWART
Last Name:FRIEDMAN
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 1:15515 3RD AVE SW
Mailing Address - Street 2:STE D
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2553
Mailing Address - Country:US
Mailing Address - Phone:206-244-1410
Mailing Address - Fax:206-244-9127
Practice Address - Street 1:15515 3RD AVE SW
Practice Address - Street 2:STE D
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2553
Practice Address - Country:US
Practice Address - Phone:206-244-1410
Practice Address - Fax:206-244-9127
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA46171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics