Provider Demographics
NPI:1639360274
Name:DR. WALTER D. FELTON, D.D.S.
Entity Type:Organization
Organization Name:DR. WALTER D. FELTON, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:D
Authorized Official - Last Name:FELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-271-9321
Mailing Address - Street 1:4121 MEADOWDALE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-5500
Mailing Address - Country:US
Mailing Address - Phone:804-271-9321
Mailing Address - Fax:804-743-4602
Practice Address - Street 1:4121 MEADOWDALE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-5500
Practice Address - Country:US
Practice Address - Phone:804-271-9321
Practice Address - Fax:804-743-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA040100064071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty