Provider Demographics
NPI:1891922746
Name:FELDON TENDLER ORTHODONTICS LLC
Entity Type:Organization
Organization Name:FELDON TENDLER ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-826-7955
Mailing Address - Street 1:595 S FEDERAL HWY
Mailing Address - Street 2:STE 130
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6011
Mailing Address - Country:US
Mailing Address - Phone:561-826-7955
Mailing Address - Fax:
Practice Address - Street 1:595 S FEDERAL HWY
Practice Address - Street 2:STE 130
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6011
Practice Address - Country:US
Practice Address - Phone:561-826-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN176651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty