Provider Demographics
NPI:1598263345
Name:SANTARELLI & FELLER DENTAL GROUP
Entity Type:Organization
Organization Name:SANTARELLI & FELLER DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:FELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:217-787-8788
Mailing Address - Street 1:1140 RICKARD ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704
Mailing Address - Country:US
Mailing Address - Phone:217-787-8788
Mailing Address - Fax:217-787-0178
Practice Address - Street 1:1140 RICKARD ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704
Practice Address - Country:US
Practice Address - Phone:217-787-8788
Practice Address - Fax:217-787-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty