Provider Demographics
NPI:1902054364
Name:ALISON T FREEMAN DMD PC
Entity Type:Organization
Organization Name:ALISON T FREEMAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BLUMENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-724-7975
Mailing Address - Street 1:7 GORWIN DR
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1309
Mailing Address - Country:US
Mailing Address - Phone:781-293-2128
Mailing Address - Fax:
Practice Address - Street 1:7 GORWIN DR
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341-1309
Practice Address - Country:US
Practice Address - Phone:781-293-2128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty