John R Faubl Valid NPI

Individual provider · General Practice Dentistry · Huntley, IL

NPI

1831112994

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

019-024211 (IL)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-07-26

Last updated

2015-09-24