Provider Demographics
NPI:1912185299
Name:FRIEDMAN, LEE E (DDS)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:E
Last Name:FRIEDMAN
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 1:12 CENTURY HILL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2123
Mailing Address - Country:US
Mailing Address - Phone:518-786-3006
Mailing Address - Fax:518-786-8007
Practice Address - Street 1:12 CENTURY HILL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2123
Practice Address - Country:US
Practice Address - Phone:518-786-3006
Practice Address - Fax:518-786-8007
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0381551223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics