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Individual

DR. RANDY SCOTT FAECHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2495 SHREVEPORT HWY, DENTAL SERVICE, ALEXANDRIA VA HEALTHCARE SYSTEM, PINEVILLE, LA 71360-4044
(318) 466-2567
Mailing address
2495 SHREVEPORT HWY, DENTAL SERVICE, ALEXANDRIA VA HEALTHCARE SYSTEM, PINEVILLE, LA 71360-4044
(318) 466-2567
(318) 466-2567

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 12491
FL

Other

Enumeration date
09/11/2013
Last updated
09/11/2013
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