Provider Demographics
NPI:1386726511
Name:BETH L FABER DDS MS PC
Entity type:Organization
Organization Name:BETH L FABER DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FABER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-443-6419
Mailing Address - Street 1:PO BOX 1686
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560
Mailing Address - Country:US
Mailing Address - Phone:804-443-6419
Mailing Address - Fax:804-443-2395
Practice Address - Street 1:1790 BALL STREET
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560
Practice Address - Country:US
Practice Address - Phone:804-443-6419
Practice Address - Fax:804-443-2395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010067911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty