Provider Demographics
NPI:1376792077
Name:VOLKMAR I. FELAHY, D.D.S. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:VOLKMAR I. FELAHY, D.D.S. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VOLKMAR
Authorized Official - Middle Name:ISAM
Authorized Official - Last Name:FELAHY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-435-5111
Mailing Address - Street 1:2161 SUNSET BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4792
Mailing Address - Country:US
Mailing Address - Phone:916-435-5111
Mailing Address - Fax:
Practice Address - Street 1:2161 SUNSET BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4792
Practice Address - Country:US
Practice Address - Phone:916-435-5111
Practice Address - Fax:916-435-5234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty