Provider Demographics
NPI:1972798825
Name:FELTON, BRETT R (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:R
Last Name:FELTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801
Mailing Address - Country:US
Mailing Address - Phone:406-728-0896
Mailing Address - Fax:406-728-0897
Practice Address - Street 1:1750 BROOKS ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801
Practice Address - Country:US
Practice Address - Phone:406-728-0896
Practice Address - Fax:406-728-0897
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2261122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist