Provider Demographics
NPI:1821008228
Name:FEIT, PAUL M (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:FEIT
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 1:2140 S RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-4357
Mailing Address - Country:US
Mailing Address - Phone:920-494-7464
Mailing Address - Fax:920-494-7919
Practice Address - Street 1:2140 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-4357
Practice Address - Country:US
Practice Address - Phone:920-494-7464
Practice Address - Fax:920-494-7919
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5727-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice