Provider Demographics
NPI:1285937748
Name:ROBERT T. FREEMAN DENTAL SOCIETY FOUNDATION
Entity type:Organization
Organization Name:ROBERT T. FREEMAN DENTAL SOCIETY FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVER TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-299-0404
Mailing Address - Street 1:81 YOST PL
Mailing Address - Street 2:
Mailing Address - City:SEAT PLEASANT
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2071
Mailing Address - Country:US
Mailing Address - Phone:202-299-0404
Mailing Address - Fax:202-299-0303
Practice Address - Street 1:81 YOST PL
Practice Address - Street 2:
Practice Address - City:SEAT PLEASANT
Practice Address - State:MD
Practice Address - Zip Code:20743-2071
Practice Address - Country:US
Practice Address - Phone:202-299-0404
Practice Address - Fax:202-299-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT460085108927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty