Provider Demographics
NPI:1780666891
Name:FREEDMAN, LAWRENCE S (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:S
Last Name:FREEDMAN
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 1:909 W MAPLE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1000
Mailing Address - Country:US
Mailing Address - Phone:248-288-0707
Mailing Address - Fax:248-288-6788
Practice Address - Street 1:909 W MAPLE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1000
Practice Address - Country:US
Practice Address - Phone:248-288-0707
Practice Address - Fax:248-288-6788
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010085671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice