Provider Demographics
NPI:1598038440
Name:DAWN-MARIE FELICETTI, DMD P.L.L.C.
Entity Type:Organization
Organization Name:DAWN-MARIE FELICETTI, DMD P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FELICETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-795-5939
Mailing Address - Street 1:4224 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6031
Mailing Address - Country:US
Mailing Address - Phone:516-795-5939
Mailing Address - Fax:516-795-2204
Practice Address - Street 1:4224 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6031
Practice Address - Country:US
Practice Address - Phone:516-795-5939
Practice Address - Fax:516-795-2204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048223261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental