Provider Demographics
NPI:1508965146
Name:FAUNCE, REBECCA A (DMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:FAUNCE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:FAUNCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:160 CYPRESS POINT PKWY
Mailing Address - Street 2:# D-217
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-8433
Mailing Address - Country:US
Mailing Address - Phone:386-446-9312
Mailing Address - Fax:386-446-9313
Practice Address - Street 1:160 CYPRESS POINT PKWY
Practice Address - Street 2:# D-217
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8433
Practice Address - Country:US
Practice Address - Phone:386-446-9312
Practice Address - Fax:386-446-9313
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN126901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics