Provider Demographics
NPI:1932182789
Name:FREEMAN, JOHN W (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SWEETBRIAR RD
Mailing Address - Street 2:#3A
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-1459
Mailing Address - Country:US
Mailing Address - Phone:864-268-5711
Mailing Address - Fax:864-268-5711
Practice Address - Street 1:25 SWEETBRIAR RD
Practice Address - Street 2:#3A
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-1459
Practice Address - Country:US
Practice Address - Phone:864-268-5711
Practice Address - Fax:864-268-5711
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice