Provider Demographics
NPI:1093725194
Name:FAUVER, CHRISTOPHER ALLEN
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:FAUVER
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:ALLEN
Other - Last Name:FAUVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2 CHESTER RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2957
Mailing Address - Country:US
Mailing Address - Phone:802-885-3191
Mailing Address - Fax:
Practice Address - Street 1:2 CHESTER RD
Practice Address - Street 2:SUITE 10
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2957
Practice Address - Country:US
Practice Address - Phone:802-885-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT21071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice