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General NPI Number Information
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NPI Number | 1386726511
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Entity Type | Organization
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Legal Business Name | BETH L FABER DDS MS PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1790 BALL STREET
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560
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Country | US
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Telephone | 804-443-6419
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Fax | 804-443-2395
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Provider Business Mailing Address
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Address Line | PO BOX 1686
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560
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Country | US
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Telephone | 804-443-6419
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Fax | 804-443-2395
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Authorized Official
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Title or Position | OWNER ORTHODONTIST
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Name | DR. BETH LYNN FABER
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Credential | DDS
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Telephone | 804-443-6419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401006791
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License Number State | VA
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