Individual
DR. COLLEEN THRESE FAHRENBACH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1500 W SAGINAW ST, LANSING, MI 48915-1380
(517) 485-8615
(517) 485-0169
Mailing address
1500 W SAGINAW ST, LANSING, MI 48915-1380
(517) 485-8615
(517) 485-0169
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15029
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2712072
—
MI
01
—
732955
UNITED CONCORDIA
MI
Enumeration date
01/12/2006
Last updated
07/08/2007
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