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Individual

DR. MICHAEL F FEDELE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
426 MULBERRY ST, SUITE 202, SCRANTON, PA 18503-1500
(570) 346-0700
(570) 983-0004
Mailing address
426 MULBERRY ST, SUITE 202, SCRANTON, PA 18503-1500
(570) 346-0700
(570) 983-0004

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS027174 L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015635300003
PA
01
402094
UNITED CONCORDIA INSURANC
PA
01
800648
FIRST PRIORITY INSURANCE
PA
Enumeration date
01/16/2007
Last updated
07/09/2007
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