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General NPI Number Information
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NPI Number | 1598038440
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Entity Type | Organization
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Legal Business Name | DAWN-MARIE FELICETTI, DMD P.L.L.C.
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 4224 MERRICK RD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6031
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Country | US
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Telephone | 516-795-5939
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Fax | 516-795-2204
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Provider Business Mailing Address
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Address Line | 4224 MERRICK RD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6031
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Country | US
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Telephone | 516-795-5939
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Fax | 516-795-2204
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. DAWN MARIE FELICETTI
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Credential | D.M.D.
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Telephone | 516-795-5939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 048223
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License Number State | NY
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