Provider Demographics
NPI:1538161310
Name:BRYAN C. FREEMAN AND CHERYL G. FREEMAN, DDS.,PA
Entity type:Organization
Organization Name:BRYAN C. FREEMAN AND CHERYL G. FREEMAN, DDS.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-625-3292
Mailing Address - Street 1:134 DAVIS ST.
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203
Mailing Address - Country:US
Mailing Address - Phone:336-625-3292
Mailing Address - Fax:336-629-3781
Practice Address - Street 1:134 DAVIS ST.
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203
Practice Address - Country:US
Practice Address - Phone:336-625-3292
Practice Address - Fax:336-629-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1538161310Medicaid
NC0262XOtherBCBS NC