Provider Demographics
NPI:1568804193
Name:FEIL ORTHODONTICS
Entity Type:Organization
Organization Name:FEIL ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-222-8668
Mailing Address - Street 1:416 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4416
Mailing Address - Country:US
Mailing Address - Phone:701-222-8668
Mailing Address - Fax:
Practice Address - Street 1:416 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4416
Practice Address - Country:US
Practice Address - Phone:701-222-8668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND20121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty