Provider Demographics
NPI:1831340017
Name:FREEMAN, PATRICK OLIVER III (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:OLIVER
Last Name:FREEMAN
Suffix:III
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 1:1216 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1604
Mailing Address - Country:US
Mailing Address - Phone:541-386-3525
Mailing Address - Fax:541-386-6647
Practice Address - Street 1:1216 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1604
Practice Address - Country:US
Practice Address - Phone:541-386-3525
Practice Address - Fax:541-386-6647
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD72031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice