Provider Demographics
NPI:1881959211
Name:DURAN, FELICIA (DDS)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:DURAN
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 1:9565 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6943
Mailing Address - Country:US
Mailing Address - Phone:954-575-3433
Mailing Address - Fax:954-575-1313
Practice Address - Street 1:9565 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6943
Practice Address - Country:US
Practice Address - Phone:954-575-3433
Practice Address - Fax:954-575-1313
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 198591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice