Individual
DR. PHILIP LOUIS FAVA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
222 CASTLEWOOD DR, BLOOMFIELD, CT 06002-1370
(631) 875-0922
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/11/2010
Last updated
07/11/2010
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