Provider Demographics
NPI:1417979733
Name:FELTHOUSEN, GREG C (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:C
Last Name:FELTHOUSEN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-7122
Mailing Address - Country:US
Mailing Address - Phone:410-548-1096
Mailing Address - Fax:410-219-5798
Practice Address - Street 1:304 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7122
Practice Address - Country:US
Practice Address - Phone:410-548-1096
Practice Address - Fax:410-219-5798
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105111223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics