Provider Demographics
NPI:1972696458
Name:FRIEDBERG, JON ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:ROBERT
Last Name:FRIEDBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 KATY FREEWAY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1360
Mailing Address - Country:US
Mailing Address - Phone:713-464-7444
Mailing Address - Fax:713-464-9728
Practice Address - Street 1:9601 KATY FREEWAY
Practice Address - Street 2:SUITE 360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1360
Practice Address - Country:US
Practice Address - Phone:713-464-7444
Practice Address - Fax:713-464-9728
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics