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General NPI Number Information
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NPI Number | 1316385206
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Entity Type | Organization
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Legal Business Name | DAVID D. FELLER PS
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 832 SHARON AVE E
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City | MOSES LAKE
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State | WA
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Zip | 98837-2442
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Country | US
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Telephone | 801-318-1644
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Fax |
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Provider Business Mailing Address
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Address Line | 832 SHARON AVE E
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City | MOSES LAKE
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State | WA
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Zip | 98837-2442
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Country | US
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Telephone | 801-318-1644
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID DANIEL FELLER
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Credential | DDS
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Telephone | 801-318-1644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE.60372518
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License Number State | WA
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