Provider Demographics
NPI:1962453878
Name:FELDMAN, WILLIAM C (DDS,PC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DDS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 UPPER RIVERDALE RD SW
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2537
Mailing Address - Country:US
Mailing Address - Phone:770-997-6600
Mailing Address - Fax:770-996-0176
Practice Address - Street 1:217 UPPER RIVERDALE RD SW
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2537
Practice Address - Country:US
Practice Address - Phone:770-997-6600
Practice Address - Fax:770-996-0176
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10128122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA429690OtherUNITED CONCORDIA