MEDICARE: DR. ANTHONY LOUIS FALCIANO DDS MAGD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	039757	NY

General Provider Information

NPI Number	:	1003804782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY LOUIS FALCIANO DDS MAGD

Provider Business Mailing Address
First Line	:	3306 WEIDNER AVE
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-2828
Country	:	US
Telephone Number	:	516-764-7995
Fax Number	:	516-255-0963

Provider Business Practice Location Address
First Line	:	3306 WEIDNER AVE
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-2828
Country	:	US
Telephone Number	:	516-764-7995
Fax Number	:	516-255-0963

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	07/08/2007

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