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General NPI Number Information
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NPI Number | 1013713981
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Entity Type | Individual
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Provider Name | ALEXANDER JAMES FAZEKAS DDS
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Gender | Male
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1640 FORT ST
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City | TRENTON
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State | MI
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Zip | 48183-2040
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Country | US
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Telephone | 734-675-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 114 W ADAMS AVE APT 1104
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City | DETROIT
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State | MI
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Zip | 48226-1632
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Country | US
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Telephone | 517-442-8652
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901602465
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License Number State | MI
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