Provider Demographics
NPI:1750548129
Name:FAJEN, VALERIE B (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:B
Last Name:FAJEN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2306 W FRANK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3519
Mailing Address - Country:US
Mailing Address - Phone:936-634-2216
Mailing Address - Fax:936-875-5424
Practice Address - Street 1:2306 W FRANK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3519
Practice Address - Country:US
Practice Address - Phone:936-634-2216
Practice Address - Fax:936-875-5424
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics