Provider Demographics
NPI:1942358437
Name:FREEMAN, TIMOTHY A JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:A
Last Name:FREEMAN
Suffix:JR
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 1:533 HILL RD N
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1159
Mailing Address - Country:US
Mailing Address - Phone:614-833-6600
Mailing Address - Fax:614-833-6654
Practice Address - Street 1:533 HILL RD N
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1159
Practice Address - Country:US
Practice Address - Phone:614-833-6600
Practice Address - Fax:614-833-6654
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH196371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice