Provider Demographics
NPI:1780898080
Name:FEENEY, OWEN (DMD)
Entity type:Individual
Prefix:DR
First Name:OWEN
Middle Name:
Last Name:FEENEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24940 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7824
Mailing Address - Country:US
Mailing Address - Phone:239-948-4886
Mailing Address - Fax:
Practice Address - Street 1:24940 S TAMIAMI TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7824
Practice Address - Country:US
Practice Address - Phone:239-948-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist