Provider Demographics
NPI:1346587177
Name:M FAY DDS INC.
Entity type:Organization
Organization Name:M FAY DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-439-9990
Mailing Address - Street 1:323 E BULLARD AVE
Mailing Address - Street 2:SUITE104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5286
Mailing Address - Country:US
Mailing Address - Phone:559-439-9990
Mailing Address - Fax:559-439-9996
Practice Address - Street 1:323 E BULLARD AVE
Practice Address - Street 2:SUITE104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5286
Practice Address - Country:US
Practice Address - Phone:559-439-9990
Practice Address - Fax:559-439-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty