Provider Demographics
NPI:1811699119
Name:C FREELOVE DDS MS PLLC.
Entity type:Organization
Organization Name:C FREELOVE DDS MS PLLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:FREELOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:916-384-8188
Mailing Address - Street 1:3014 ISSAQUAH PINE LAKE RD SE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98075-7253
Mailing Address - Country:US
Mailing Address - Phone:425-651-2778
Mailing Address - Fax:
Practice Address - Street 1:3014 ISSAQUAH-PINE LAKE RD SE
Practice Address - Street 2:SUITE B
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98075-7253
Practice Address - Country:US
Practice Address - Phone:425-651-2778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMERON FREELOVE DDS MS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-20
Last Update Date:2024-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty