MEDICARE: DR. REBECCA A FACY M.D.,D.D.S.

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	8955	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8955	OTHER	CO	STATE LICENSE

General Provider Information

NPI Number	:	1407854102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA A FACY M.D.,D.D.S.

Provider Business Mailing Address
First Line	:	595 CHAPEL HILLS DR
Second Line	:	#300
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1022
Country	:	US
Telephone Number	:	719-599-0500
Fax Number	:	719-599-0575

Provider Business Practice Location Address
First Line	:	595 CHAPEL HILLS DR
Second Line	:	#300
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1022
Country	:	US
Telephone Number	:	719-599-0500
Fax Number	:	719-599-0575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. REBECCA A FACY M.D.,D.D.S.” Practice Location

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