Provider Demographics
NPI:1992012934
Name:FABER, BETH LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:LYNN
Last Name:FABER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1686
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560-1686
Mailing Address - Country:US
Mailing Address - Phone:804-443-6419
Mailing Address - Fax:804-443-2395
Practice Address - Street 1:1790 BALL ST
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560-1790
Practice Address - Country:US
Practice Address - Phone:804-443-6419
Practice Address - Fax:804-443-2395
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010067911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics