Provider Demographics
NPI:1265629950
Name:MARK J FABEY DMD, PC
Entity Type:Organization
Organization Name:MARK J FABEY DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:FABEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-253-4400
Mailing Address - Street 1:2690 KINGSTON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8011
Mailing Address - Country:US
Mailing Address - Phone:610-253-4400
Mailing Address - Fax:610-253-4600
Practice Address - Street 1:2690 KINGSTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8011
Practice Address - Country:US
Practice Address - Phone:610-253-4400
Practice Address - Fax:610-253-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028645L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty