| Fair Haven Dental | |
|
129b N Main St Fair Haven VT 05743-1132 | |
| (802) 265-3604 | |
| (802) 251-0022 |
| Full Name | Fair Haven Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 129b N Main St, Fair Haven, Vermont |
| Authorized Official Name and Position | Fadi Jamil Hawwash (OWNER) |
| Authorized Official Contact | 8022653604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fair Haven Dental Po Box 37 Fair Haven VT 05743-0037 Ph: (802) 265-3604 | Fair Haven Dental 129b N Main St Fair Haven VT 05743-1132 Ph: (802) 265-3604 |
| NPI Number | 1174814156 |
|---|---|
| Provider Enumeration Date | 04/26/2011 |
| Last Update Date | 04/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174814156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |