Provider Demographics
NPI:1780088625
Name:ADRIENNE U. FEYOCK DDS, INC.
Entity type:Organization
Organization Name:ADRIENNE U. FEYOCK DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:U
Authorized Official - Last Name:FEYOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-837-7277
Mailing Address - Street 1:300 EL CERRO BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1744
Mailing Address - Country:US
Mailing Address - Phone:925-837-7277
Mailing Address - Fax:925-831-1876
Practice Address - Street 1:300 EL CERRO BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1744
Practice Address - Country:US
Practice Address - Phone:925-837-7277
Practice Address - Fax:925-831-1876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty