Provider Demographics
NPI:1326454133
Name:VINCENT, FELIX (DDS)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:
Last Name:VINCENT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 PROSSER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-4234
Mailing Address - Country:US
Mailing Address - Phone:931-766-6670
Mailing Address - Fax:
Practice Address - Street 1:185 PROSSER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4234
Practice Address - Country:US
Practice Address - Phone:931-766-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001471122300000X
TN102521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist