Provider Demographics
NPI:1457475774
Name:FELTON, JOHN FRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRED
Last Name:FELTON
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 1:6 CHESTNUT CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1441
Mailing Address - Country:US
Mailing Address - Phone:410-455-9893
Mailing Address - Fax:410-455-5380
Practice Address - Street 1:606 FREDERICK RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4625
Practice Address - Country:US
Practice Address - Phone:410-455-9893
Practice Address - Fax:410-455-5380
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD80621223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics