Provider Demographics
NPI:1427469717
Name:ABIGAIL FAUL, DDS PC
Entity type:Organization
Organization Name:ABIGAIL FAUL, DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-554-3872
Mailing Address - Street 1:530 IOWA AVE SE STE 103
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-2859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:530 IOWA AVE SE STE 103
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2859
Practice Address - Country:US
Practice Address - Phone:605-352-3183
Practice Address - Fax:605-352-3170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty