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General NPI Number Information
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NPI Number | 1902054588
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Entity Type | Organization
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Legal Business Name | MARVIN R. FELDMAN, DMD, PA
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 12/05/2013
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Provider Practice Location Address
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Address Line | 224 S OLD DIXIE HWY
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City | JUPITER
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State | FL
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Zip | 33458-7487
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Country | US
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Telephone | 561-748-4488
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Fax | 561-748-7849
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Provider Business Mailing Address
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Address Line | 224 S OLD DIXIE HWY
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City | JUPITER
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State | FL
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Zip | 33458-7487
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Country | US
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Telephone | 561-748-4488
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Fax | 561-748-7849
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARVIN ROY FELDMAN
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Credential | D.M.D.,P.A.
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Telephone | 561-748-4488
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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 | 14849
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License Number State | FL
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