Provider Demographics
NPI:1245442276
Name:FELDSTEIN, BRUCE M (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:FELDSTEIN
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 1:30 AIRPORT RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-1664
Mailing Address - Country:US
Mailing Address - Phone:603-298-7660
Mailing Address - Fax:603-298-8135
Practice Address - Street 1:30 AIRPORT RD
Practice Address - Street 2:SUITE #3
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1664
Practice Address - Country:US
Practice Address - Phone:603-298-7660
Practice Address - Fax:603-298-8135
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice