Provider Demographics
NPI:1538336920
Name:FREEDOM DENTAL LTD
Entity type:Organization
Organization Name:FREEDOM DENTAL LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAREEF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-488-9145
Mailing Address - Street 1:1185 DUNDEE AVE
Mailing Address - Street 2:STE A1
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120
Mailing Address - Country:US
Mailing Address - Phone:847-488-9145
Mailing Address - Fax:847-488-9147
Practice Address - Street 1:1185 DUNDEE AVE
Practice Address - Street 2:STE A1
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120
Practice Address - Country:US
Practice Address - Phone:847-488-9145
Practice Address - Fax:847-488-9147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL629404761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty