Provider Demographics
NPI:1184699092
Name:FELTON, WALTER D (DDS)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:D
Last Name:FELTON
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 1:10611 GREENYARD WAY
Mailing Address - Street 2:STE. A
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831
Mailing Address - Country:US
Mailing Address - Phone:804-717-2099
Mailing Address - Fax:804-717-9383
Practice Address - Street 1:10611 GREENYARD WAY
Practice Address - Street 2:STE. A
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831
Practice Address - Country:US
Practice Address - Phone:804-717-2099
Practice Address - Fax:804-717-9383
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010064071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice