Provider Demographics
NPI:1790976553
Name:DR ANDREW D FRIEDMAN DMD
Entity Type:Organization
Organization Name:DR ANDREW D FRIEDMAN DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-696-4681
Mailing Address - Street 1:21 OLD POINT AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:ME
Mailing Address - Zip Code:04950-1114
Mailing Address - Country:US
Mailing Address - Phone:207-696-4681
Mailing Address - Fax:207-696-5345
Practice Address - Street 1:21 OLD POINT AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:ME
Practice Address - Zip Code:04950-1114
Practice Address - Country:US
Practice Address - Phone:207-696-4681
Practice Address - Fax:207-696-5345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2661261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental