Healthcare Provider Details

I. General information

NPI: 1356077515
Provider Name (Legal Business Name): FALIK FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 W LAWRENCE AVE
CHARLOTTE MI
48813-1326
US

IV. Provider business mailing address

790 W LAWRENCE AVE
CHARLOTTE MI
48813-1326
US

V. Phone/Fax

Practice location:
  • Phone: 517-543-3143
  • Fax: 517-543-2909
Mailing address:
  • Phone: 517-543-3143
  • Fax: 517-543-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT C FALIK
Title or Position: OWNER
Credential: DDS
Phone: 517-543-3143