Provider Demographics
NPI:1972604429
Name:FELT, ERIC C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:FELT
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 1:7956 WILLOW CIR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6270
Mailing Address - Country:US
Mailing Address - Phone:801-942-3542
Mailing Address - Fax:801-942-3572
Practice Address - Street 1:215 S 1000 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2403
Practice Address - Country:US
Practice Address - Phone:801-533-9879
Practice Address - Fax:801-366-9497
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist