Provider Demographics
NPI:1457585606
Name:FELTON, JEAN MARIE
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:MARIE
Last Name:FELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 E LOWRY BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7255
Mailing Address - Country:US
Mailing Address - Phone:703-980-4541
Mailing Address - Fax:
Practice Address - Street 1:8111 E LOWRY BLVD
Practice Address - Street 2:STE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7255
Practice Address - Country:US
Practice Address - Phone:703-980-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-02
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002019051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry