Provider Demographics
NPI:1356443501
Name:JAMES A. FABER, D.D.S., PC
Entity Type:Organization
Organization Name:JAMES A. FABER, D.D.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:FABER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-916-0600
Mailing Address - Street 1:2747 W CLAY ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2557
Mailing Address - Country:US
Mailing Address - Phone:636-916-0600
Mailing Address - Fax:636-916-3909
Practice Address - Street 1:2747 W CLAY ST
Practice Address - Street 2:SUITE D
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2557
Practice Address - Country:US
Practice Address - Phone:636-916-0600
Practice Address - Fax:636-916-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty