Provider Demographics
NPI:1689860835
Name:FAUSTINI, FREDERICK R (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:R
Last Name:FAUSTINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:CROTON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10519
Mailing Address - Country:US
Mailing Address - Phone:914-277-3919
Mailing Address - Fax:914-277-5580
Practice Address - Street 1:ROUTE 22
Practice Address - Street 2:
Practice Address - City:CROTON FALLS
Practice Address - State:NY
Practice Address - Zip Code:10519
Practice Address - Country:US
Practice Address - Phone:914-277-3919
Practice Address - Fax:914-277-5580
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042337-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist