Provider Demographics
NPI:1780858001
Name:DONALD I FAUSNAUGHT INC
Entity Type:Organization
Organization Name:DONALD I FAUSNAUGHT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:I
Authorized Official - Last Name:FAUSNAUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-569-4446
Mailing Address - Street 1:1891 FRUITVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4011
Mailing Address - Country:US
Mailing Address - Phone:717-569-4446
Mailing Address - Fax:717-569-6433
Practice Address - Street 1:1891 FRUITVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4011
Practice Address - Country:US
Practice Address - Phone:717-569-4446
Practice Address - Fax:717-569-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA26778122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty