Provider Demographics
NPI:1063908770
Name:FABER, TRAVIS WRIGHT (DDS)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:WRIGHT
Last Name:FABER
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 1:2711 GROVE AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4349
Mailing Address - Country:US
Mailing Address - Phone:757-646-0186
Mailing Address - Fax:
Practice Address - Street 1:2930 W HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2126
Practice Address - Country:US
Practice Address - Phone:804-621-7631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014161531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice