| Organization Name: | MITCHEL L. FRIEDMAN, DDS, FAGD, LLC |
| NPI Number: | 1134262579 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MITCHEL LEE FRIEDMAN (MEMBER) |
| Mailing Address: | 539 Newman Springs Rd Lincroft |
| State: | NJ US |
| Postal Code: | 077381425 |
| Phone Number: | 7327416444 |
| Fax Number: | 7327418121 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | NJ 22DI01479600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |