=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548550403
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANELIN FEILEN DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2011
-----------------------------------------------------
Last Update Date | 02/22/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3132 MARKET PL SUITE 300
-----------------------------------------------------
City | ONALASKA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54650-6705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-783-5800
-----------------------------------------------------
Fax | 608-783-5828
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3132 MARKET PL SUITE 300
-----------------------------------------------------
City | ONALASKA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54650-6705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-783-5800
-----------------------------------------------------
Fax | 608-783-5828
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 6661-15
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------