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NPI Code Detail

MEDICARE: DR. GARY MASON FEISEL DDS

MEDICARE: DR. GARY MASON FEISEL 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
11223G0001XGeneral Practice Dentistry14627TX

General Provider Information

NPI Number : 1407862105
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY MASON FEISEL DDS
Provider Business Mailing Address
First Line : 8515 GREENVILLE AVE STE S201
Second Line :
City : DALLAS
State : TX
Zip : 75243-7037
Country : US
Telephone Number : 214-343-6762
Fax Number :
Provider Business Practice Location Address
First Line : 8515 GREENVILLE AVE STE S201
Second Line :
City : DALLAS
State : TX
Zip : 75243-7037
Country : US
Telephone Number : 214-343-6762
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GARY MASON FEISEL DDS” Practice Location

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