Provider Demographics
NPI:1407992647
Name:STEPHEN T. FABRY D.D.S. INC.
Entity Type:Organization
Organization Name:STEPHEN T. FABRY D.D.S. INC.
Other - Org Name:FALLS FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOCASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-929-5496
Mailing Address - Street 1:465 E BATH RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2511
Mailing Address - Country:US
Mailing Address - Phone:330-929-5496
Mailing Address - Fax:330-929-6292
Practice Address - Street 1:465 E BATH RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2511
Practice Address - Country:US
Practice Address - Phone:330-929-5496
Practice Address - Fax:330-929-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH180891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty