Organization
JEFFREY S. FELTZER, DMD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY S. FELTZER DMD (PRESIDENT)
(574) 309-4791
Entity
Organization
Contact information
Practice address
518 LINCOLNWAY W, MISHAWAKA, IN 46544-1807
(574) 255-5630
Mailing address
PO BOX 806, MIDDLEBURY, IN 46540-0806
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010107A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200432580
—
IN
Enumeration date
11/11/2009
Last updated
11/11/2009
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