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NPI Code Detail

MEDICARE: LISA M FEHELEY DDS

MEDICARE: LISA M FEHELEY 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
1122300000XDentistDEN.00006783CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487626081
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA M FEHELEY DDS
Provider Business Mailing Address
First Line : 203 S ROLLIE AVE
Second Line :
City : FORT LUPTON
State : CO
Zip : 80621-1508
Country : US
Telephone Number : 303-286-4560
Fax Number : 303-286-4589
Provider Business Practice Location Address
First Line : 6255 QUEBEC PKWY
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-4812
Country : US
Telephone Number : 303-286-6755
Fax Number : 303-286-8260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 11/08/2013

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Directions to “ LISA M FEHELEY DDS” Practice Location

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