Individual
DR. BRIAN FABB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
21 ELLEN PL, KINGS PARK, NY 11754-3605
(917) 968-3730
Mailing address
21 ELLEN PL, KINGS PARK, NY 11754-3605
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
053371
NY
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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