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General NPI Number Information
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NPI Number | 1538896733
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Entity Type | Individual
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Provider Name | MICHAEL PATRICK FEENEY DDS
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Gender | Male
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Dates
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Enumeration Date | 08/07/2022
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Last Update Date | 08/07/2022
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Provider Practice Location Address
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Address Line | N14W23833 STONE RIDGE DR
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City | WAUKESHA
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State | WI
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Zip | 53188-1157
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Country | US
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Telephone | 262-542-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 133 W OREGON ST APT 513
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City | MILWAUKEE
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State | WI
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Zip | 53204-1482
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Country | US
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Telephone | 701-516-2769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6001057-15
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License Number State | WI
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