Individual
KEVIN MARK FAHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
600 EAST GENESEE ST, SYRACUSE, NY 13202
(315) 476-7406
(315) 476-7408
Mailing address
600 EAST GENESEE ST, SYRACUSE, NY 13202
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DN15647
FL
1223E0200X
Endodontics
Primary
NY050049
NY
Other
Enumeration date
08/15/2007
Last updated
08/15/2007
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