Provider Demographics
NPI:1871742932
Name:FEY, EDMUND H (DDS)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:H
Last Name:FEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56928 BUCKHORN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH FORK
Mailing Address - State:CA
Mailing Address - Zip Code:93643-9572
Mailing Address - Country:US
Mailing Address - Phone:559-877-2414
Mailing Address - Fax:
Practice Address - Street 1:56928 BUCKHORN CT
Practice Address - Street 2:
Practice Address - City:NORTH FORK
Practice Address - State:CA
Practice Address - Zip Code:93643-9572
Practice Address - Country:US
Practice Address - Phone:559-877-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-14
Last Update Date:2008-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist