Provider Demographics
NPI:1922197250
Name:FREEMAN, DANIEL DERRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DERRICK
Last Name:FREEMAN
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 1:2567 APPLING RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-5099
Mailing Address - Country:US
Mailing Address - Phone:901-383-7337
Mailing Address - Fax:301-507-1390
Practice Address - Street 1:2567 APPLING RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-5099
Practice Address - Country:US
Practice Address - Phone:901-383-7337
Practice Address - Fax:301-507-1390
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDD77671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry