Provider Demographics
NPI:1629253695
Name:URREA-FELDSBERG DDS,MDS,PA
Entity Type:Organization
Organization Name:URREA-FELDSBERG DDS,MDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:URREA-FELDSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MDS
Authorized Official - Phone:954-966-7762
Mailing Address - Street 1:5440 SHADY OAK LANE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6224
Mailing Address - Country:US
Mailing Address - Phone:954-966-7762
Mailing Address - Fax:954-966-7762
Practice Address - Street 1:5440 SHADY OAK LANE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6224
Practice Address - Country:US
Practice Address - Phone:954-966-7762
Practice Address - Fax:954-966-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty