Provider Demographics
NPI:1023100971
Name:DR GEORGE FREED AND DR JEFFREY GLIKSMAN
Entity type:Organization
Organization Name:DR GEORGE FREED AND DR JEFFREY GLIKSMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-384-3909
Mailing Address - Street 1:155 NORTH WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1742
Mailing Address - Country:US
Mailing Address - Phone:201-384-3909
Mailing Address - Fax:201-384-7373
Practice Address - Street 1:155 NORTH WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1742
Practice Address - Country:US
Practice Address - Phone:201-384-3909
Practice Address - Fax:201-384-7373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty