MEDICARE: WALTER D. FELTON, DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401006407	VA

General Provider Information

NPI Number	:	1174075436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALTER D. FELTON, DDS

Provider Business Mailing Address
First Line	:	10611 GREENYARD WAY
Second Line	:	STE A
City	:	CHESTER
State	:	VA
Zip	:	23831-1484
Country	:	US
Telephone Number	:	804-717-2099
Fax Number	:	804-717-9383

Provider Business Practice Location Address
First Line	:	10611 GREENYARD WAY
Second Line	:	STE A
City	:	CHESTER
State	:	VA
Zip	:	23831-1484
Country	:	US
Telephone Number	:	804-717-2099
Fax Number	:	804-717-9383

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. WALTER D FELTON
Credential	:	DDS
Telephone Number	:	804-717-2099

Provider Enumeration Date	:	11/02/2016
Last Update Date	:	11/02/2016

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