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Individual

DR. KENNETH GREGORY FELLERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
55 EAST 210TH ST, SUITE 1B, BRONX, NY 10467
(718) 547-8200
(718) 547-6540
Mailing address
55 EAST 210TH ST, BRONX, NY 10467
(718) 547-8200
(718) 547-6540

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
033489
NY

Other

Enumeration date
09/04/2008
Last updated
09/04/2008
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