Provider Demographics
NPI:1790853182
Name:FASY, JAMES JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:FASY
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 1:1010 G A R HWY
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4566
Mailing Address - Country:US
Mailing Address - Phone:508-679-5291
Mailing Address - Fax:508-679-9200
Practice Address - Street 1:1010 G A R HWY
Practice Address - Street 2:SWANSEA PROFESSIONAL PARK
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4566
Practice Address - Country:US
Practice Address - Phone:508-679-5291
Practice Address - Fax:508-679-9200
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics