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General NPI Number Information
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NPI Number | 1831447325
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Entity Type | Individual
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Provider Name | ABIGAIL FAUL
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 64 STOCKADE RD
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City | SUMMERVILLE
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State | GA
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Zip | 30747-1900
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Country | US
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Telephone | 706-857-2323
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Fax | 706-857-7041
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Provider Business Mailing Address
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Address Line | 9 PIPPIN PL NE
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City | ROME
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State | GA
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Zip | 30165-9158
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Country | US
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Telephone | 785-554-3872
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN014417
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License Number State | GA
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