Provider Demographics
NPI:1710930581
Name:FEUCHT, GARY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:R
Last Name:FEUCHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40400 ANN ARBOR RD E
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-6615
Mailing Address - Country:US
Mailing Address - Phone:734-459-7110
Mailing Address - Fax:734-459-0314
Practice Address - Street 1:40400 ANN ARBOR RD E
Practice Address - Street 2:SUITE 103
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6615
Practice Address - Country:US
Practice Address - Phone:734-459-7110
Practice Address - Fax:734-459-0314
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010118041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice