Fedak, Daryl Alvan
Fedak, Daryl Alvan is an individual health care provider with primary practice located at 5892 Main St Ste 1, Springfield OR 97478-5496. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Fedak, Daryl Alvan can be contacted via phone (541) 741-7800.Contact Information
Primary practice address
5892 Main St Ste 1
Springfield OR 97478-5496
Phone: (541) 741-7800
Fax: (541) 741-7888
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D7742 | Oregon |
Profile Details
| NPI number | 1033117288 |
|---|---|
| LBN Legal business name | Fedak, Daryl Alvan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033117288 | NPPES |
| Other | 7696119 | AETNA | |
| Other | 1407366 | AETNA |
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