Individual
HEATHER FAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1213 RR 620 S, SUITE 205, LAKEWAY, TX 78734-6340
(512) 263-8337
Mailing address
1213 RR 620 S, SUITE 205, LAKEWAY, TX 78734-6340
(512) 263-8337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22070
TX
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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