Individual
DR. BRENT JORDAN FREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6525 BELCREST RD STE 290, HYATTSVILLE, MD 20782-2062
(301) 249-4123
Mailing address
6525 BELCREST RD STE 290, HYATTSVILLE, MD 20782-2062
(248) 376-1059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401412360
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
14696
MD
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DEN1000872
DC
Other
Enumeration date
01/07/2011
Last updated
01/22/2024
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