MEDICARE: DR. JOHN C FELTON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18014	OH

General Provider Information

NPI Number	:	1336162585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN C FELTON DDS

Provider Business Mailing Address
First Line	:	40 CLAY ST
Second Line	:
City	:	TIFFIN
State	:	OH
Zip	:	44883-2241
Country	:	US
Telephone Number	:	419-447-3050
Fax Number	:	419-447-3088

Provider Business Practice Location Address
First Line	:	40 CLAY ST
Second Line	:
City	:	TIFFIN
State	:	OH
Zip	:	44883-2241
Country	:	US
Telephone Number	:	419-447-3050
Fax Number	:	419-447-3088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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