Provider Demographics
NPI:1366553307
Name:FABER, BETH ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:BETH ANN
Middle Name:
Last Name:FABER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 WEST GRAND RIVER AVENUE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895
Mailing Address - Country:US
Mailing Address - Phone:517-655-1500
Mailing Address - Fax:517-655-8560
Practice Address - Street 1:425 WEST GRAND RIVER AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895
Practice Address - Country:US
Practice Address - Phone:517-655-1500
Practice Address - Fax:517-655-8560
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0169771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice