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General NPI Number Information
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NPI Number | 1689600777
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Entity Type | Organization
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Legal Business Name | FASY&BROWN ORTHODONTICS L.L.C.
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1010 G A R HWY.
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City | SWANSEA
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State | MA
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Zip | 02777-4566
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Country | US
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Telephone | 508-679-5291
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Fax | 508-679-9200
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Provider Business Mailing Address
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Address Line | 1010 GRAND ARMY OF THE REPUBLIC HWY.
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City | SWANSEA
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State | MA
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Zip | 02777-4566
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Country | US
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Telephone | 508-679-5291
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Fax | 508-679-9200
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JAMES JOSEPH FASY
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Credential | D.D.S.
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Telephone | 508-679-5291
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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 | 11208
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License Number State | MA
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