Healthcare Provider Details

I. General information

NPI: 1245937135
Provider Name (Legal Business Name): FEEL GOOD DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VESTAVIA PKWY STE 120
VESTAVIA AL
35216-3750
US

IV. Provider business mailing address

400 VESTAVIA PKWY STE 120
VESTAVIA AL
35216-3750
US

V. Phone/Fax

Practice location:
  • Phone: 205-225-9878
  • Fax:
Mailing address:
  • Phone: 205-225-9878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MARC CHRISTOPHER VANCE
Title or Position: PRESIDENT
Credential:
Phone: 205-225-9878