Provider Demographics
NPI:1710153200
Name:FRIEDMAN, MICHAEL CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CRAIG
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1175 PEACHTREE ST NE
Mailing Address - Street 2:100 COLONY SQUARE SUITE 1210
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30361-6202
Mailing Address - Country:US
Mailing Address - Phone:404-874-6464
Mailing Address - Fax:404-874-1831
Practice Address - Street 1:1175 PEACHTREE ST NE
Practice Address - Street 2:100 COLONY SQUARE SUITE 1210
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30361-6202
Practice Address - Country:US
Practice Address - Phone:404-874-6464
Practice Address - Fax:404-874-1831
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist