# FDA PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fenton Dental Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295805026
- **Authorized official:** DR. JULIE KATHLEEN LEZOTTE (OWNER)
- **Authorized official phone:** (810) 629-5454

## Contact information

- **Practice address:** 1535 N LEROY, F, FENTON, MI 48430
- **Practice address phone:** (810) 629-5454
- **Practice address fax:** (810) 629-8932
- **Mailing address:** 1535 N LEROY, F, FENTON, MI 48430
- **Mailing address phone:** (810) 629-5454
- **Mailing address fax:** (810) 629-8932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901017712 | MI | Yes |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 08/22/2020