Provider Demographics
NPI:1558571646
Name:FRIEDMAN, HEATHER MICHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MICHELLE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7906 TERRAPIN CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3126
Mailing Address - Country:US
Mailing Address - Phone:410-486-1776
Mailing Address - Fax:
Practice Address - Street 1:4134 E JOPPA RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2284
Practice Address - Country:US
Practice Address - Phone:410-256-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist