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DR. MAURICE JEROME FREEMAN D.M.D.
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1457572513
Individual Registrant:DR. MAURICE JEROME FREEMAN D.M.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
708 S GRANT ST BLDG 20 FITZGERALD, GA 31750-3788 US
Tel: 229-423-9308 Fax: 229-423-9309
Tel: 229-423-9308 Fax: 229-423-9309
Contact information for business:
PO BOX 5070 FITZGERALD, GA 31750-5070 US
Tel: 229-423-9308 Fax: 229-423-9309
Tel: 229-423-9308 Fax: 229-423-9309
Registration Information:
NPI: 1457572513
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | GA | 010397 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
