Individual
JODY FREYTAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
403 N MAIN ST, WALBRIDGE, OH 43465-1018
(419) 666-1776
Mailing address
476 SYCAMORE LN, WATERVILLE, OH 43566-1252
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21562
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2636651
—
OH
Enumeration date
04/19/2007
Last updated
07/08/2007
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