MEDICARE: JAMES A. FABER, D.D.S., PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1356443501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES A. FABER, D.D.S., PC

Provider Business Mailing Address
First Line	:	2747 W CLAY ST
Second Line	:	SUITE D
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-2557
Country	:	US
Telephone Number	:	636-916-0600
Fax Number	:	636-916-3909

Provider Business Practice Location Address
First Line	:	2747 W CLAY ST
Second Line	:	SUITE D
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-2557
Country	:	US
Telephone Number	:	636-916-0600
Fax Number	:	636-916-3909

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES ALVIN FABER
Credential	:	D.D.S.
Telephone Number	:	636-916-0600

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	08/22/2020

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