Provider Demographics
NPI:1811684129
Name:THOMAS G. FAIVER DDS PC
Entity type:Organization
Organization Name:THOMAS G. FAIVER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:FAIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-351-7222
Mailing Address - Street 1:1350 E LAKE LANSING RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-7413
Mailing Address - Country:US
Mailing Address - Phone:517-351-7222
Mailing Address - Fax:517-351-0030
Practice Address - Street 1:1350 E LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-7413
Practice Address - Country:US
Practice Address - Phone:517-351-7222
Practice Address - Fax:517-351-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental