Provider Demographics
NPI:1396888343
Name:FRIEDEL, LEE M (DDS)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:M
Last Name:FRIEDEL
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 1:1605 TOWN CENTER BLVD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326
Mailing Address - Country:US
Mailing Address - Phone:954-389-0511
Mailing Address - Fax:954-389-5323
Practice Address - Street 1:1605 TOWN CENTER CIR
Practice Address - Street 2:SUITE B
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3637
Practice Address - Country:US
Practice Address - Phone:954-389-0511
Practice Address - Fax:954-389-5323
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7855122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist