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General NPI Number Information
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NPI Number | 1790575280
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Entity Type | Individual
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Provider Name | DALTON LYLE FALER OD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/24/2025
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Provider Practice Location Address
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Address Line | 2150 EWING CRAWFIS CIR
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-9042
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Country | US
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Telephone | 937-593-1766
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Fax |
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Provider Business Mailing Address
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Address Line | 4843 TOWNSHIP ROAD 56
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City | HUNTSVILLE
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State | OH
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Zip | 43324-9786
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Country | US
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Telephone | 937-407-4881
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.007370
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License Number State | OH
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