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Organization

JENNIFER M FEDON DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER MARIE FEDON DDS (DENTIST)
(586) 604-5455
Entity
Organization

Contact information

Practice address
5805 24 MILE RD STE A, SHELBY TOWNSHIP, MI 48316-3281
(586) 604-5455
(586) 677-5567
Mailing address
5805 24 MILE RD STE A, SHELBY TOWNSHIP, MI 48316-3281
(586) 604-5455
(586) 677-5567

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F350398585901
DRIVERS LICENSE
MI
Enumeration date
07/06/2022
Last updated
08/02/2022
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