Provider Demographics
NPI:1700065562
Name:FEEKART, MARY E (DDS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:FEEKART
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E HILL ST
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-3612
Mailing Address - Country:US
Mailing Address - Phone:562-981-5816
Mailing Address - Fax:562-981-5074
Practice Address - Street 1:777 BROADWAY ST
Practice Address - Street 2:SUITE B
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-2568
Practice Address - Country:US
Practice Address - Phone:765-642-3124
Practice Address - Fax:765-642-1095
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56474122300000X
IN12011111A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist