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Individual

DR. CHAD WILLIAM FEGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
24760 HOSPITAL DRIVE, RED LAKE, MN 56671
(218) 679-3912
(218) 679-0189
Mailing address
12970 DUNHAM RD, HARTLAND, MI 48353-2118
(218) 679-3912
(218) 679-0189

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020243
MI

Other

Enumeration date
08/10/2010
Last updated
08/10/2010
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