Individual
DEBRA S FAIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
459 INDUSTRIAL LN, ONEIDA, TN 37841-6202
(423) 569-3456
Mailing address
281 WOODLAND PL, HUNTSVILLE, TN 37756-3800
(423) 663-8658
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS5240
TN
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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