Provider Demographics
NPI:1376553495
Name:FELDER, BRUCE K (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:K
Last Name:FELDER
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 1:3000 LANGLEY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4700
Mailing Address - Country:US
Mailing Address - Phone:850-477-2323
Mailing Address - Fax:
Practice Address - Street 1:3000 LANGLEY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4700
Practice Address - Country:US
Practice Address - Phone:850-477-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL84141223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics