Provider Demographics
NPI:1720109523
Name:FREEMAN, ERMA LAVAUGHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERMA
Middle Name:LAVAUGHAN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 BEAVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-7138
Mailing Address - Country:US
Mailing Address - Phone:434-447-4341
Mailing Address - Fax:
Practice Address - Street 1:1147 PLANTERS RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23868-3345
Practice Address - Country:US
Practice Address - Phone:434-848-4131
Practice Address - Fax:434-848-0936
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010052271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice