Provider Demographics
NPI:1538175732
Name:FRIEDMAN, PHILIP I (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:I
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 1:6803 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2509
Mailing Address - Country:US
Mailing Address - Phone:912-354-7693
Mailing Address - Fax:912-354-8762
Practice Address - Street 1:6803 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2509
Practice Address - Country:US
Practice Address - Phone:912-354-7693
Practice Address - Fax:912-354-8762
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA112481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice