Provider Demographics
NPI:1730341892
Name:FEINAUER, JON CHRISTOPH (DDS)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:CHRISTOPH
Last Name:FEINAUER
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 1:1016 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1238
Mailing Address - Country:US
Mailing Address - Phone:248-320-5695
Mailing Address - Fax:248-320-5695
Practice Address - Street 1:380 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-1306
Practice Address - Country:US
Practice Address - Phone:616-866-1017
Practice Address - Fax:616-866-1017
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019859122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist