Provider Demographics
NPI:1699079442
Name:MARCUS A FAIRBANKS DDS & DARCY R GALBRAITH,
Entity type:Organization
Organization Name:MARCUS A FAIRBANKS DDS & DARCY R GALBRAITH,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-676-9050
Mailing Address - Street 1:3628 MERIDIAN
Mailing Address - Street 2:SUITE 1-B
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:360-676-9050
Mailing Address - Fax:360-676-1593
Practice Address - Street 1:3628 MERIDIAN
Practice Address - Street 2:SUITE 1-B
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225
Practice Address - Country:US
Practice Address - Phone:360-676-9050
Practice Address - Fax:360-676-1593
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARCUS A FAIRBANKS DDS & DARCY R GALBRAITH DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00005114122300000X
WADE00010402122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty