Provider Demographics
NPI:1811152002
Name:MARGERY F FRIDAY DDS PA
Entity type:Organization
Organization Name:MARGERY F FRIDAY DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGERY
Authorized Official - Middle Name:FLOYD
Authorized Official - Last Name:FRIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-340-0621
Mailing Address - Street 1:5207 SHENANDOAH CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1712
Mailing Address - Country:US
Mailing Address - Phone:239-340-0621
Mailing Address - Fax:
Practice Address - Street 1:5207 SHENANDOAH CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1712
Practice Address - Country:US
Practice Address - Phone:239-340-0621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN81591223G0001X
TNDS34221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty