Provider Demographics
NPI:1447357496
Name:FRIEDMAN, MITCHELL (DDS)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8795 RALSTON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2353
Mailing Address - Country:US
Mailing Address - Phone:303-422-8942
Mailing Address - Fax:303-422-2848
Practice Address - Street 1:8795 RALSTON RD STE 210
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2353
Practice Address - Country:US
Practice Address - Phone:303-422-8942
Practice Address - Fax:303-422-2848
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1044621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice