Healthcare Provider Details

I. General information

NPI: 1245427434
Provider Name (Legal Business Name): JAY C. FEINGLASS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33533 W 12 MILE RD SUITE 150
FARMINGTON HILLS MI
48331-3354
US

IV. Provider business mailing address

1 OAK HOLLOW CT
PIKESVILLE MD
21208-1854
US

V. Phone/Fax

Practice location:
  • Phone: 888-833-8441
  • Fax: 888-330-4331
Mailing address:
  • Phone: 410-484-2224
  • Fax: 410-576-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4607
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: