Provider Demographics
NPI:1144838095
Name:FREYBLER, ABRAHAM (DDS)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:FREYBLER
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 1:1515 SAINT FRANCIS AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-4307
Mailing Address - Country:US
Mailing Address - Phone:952-496-1538
Mailing Address - Fax:
Practice Address - Street 1:1515 SAINT FRANCIS AVE STE 145
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-4307
Practice Address - Country:US
Practice Address - Phone:952-496-1538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist