Healthcare Provider Details

I. General information

NPI: 1801993720
Provider Name (Legal Business Name): STEPHEN J FALCO JR DMD PC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 STATE STREET
WARREN RI
02885
US

IV. Provider business mailing address

38 STATE STREET
WARREN RI
02885
US

V. Phone/Fax

Practice location:
  • Phone: 401-245-6131
  • Fax: 401-245-5152
Mailing address:
  • Phone: 401-245-6131
  • Fax: 401-245-5152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN02255
License Number StateRI

VIII. Authorized Official

Name: STEPHEN JAMES FALCO JR.
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 401-245-6131