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General NPI Number Information
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NPI Number | 1801993720
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Entity Type | Organization
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Legal Business Name | STEPHEN J FALCO JR DMD PC LTD
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 38 STATE STREET
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City | WARREN
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State | RI
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Zip | 02885
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Country | US
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Telephone | 401-245-6131
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Fax | 401-245-5152
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Provider Business Mailing Address
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Address Line | 38 STATE STREET
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City | WARREN
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State | RI
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Zip | 02885
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Country | US
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Telephone | 401-245-6131
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Fax | 401-245-5152
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | STEPHEN JAMES FALCO JR.
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Credential | DMD
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Telephone | 401-245-6131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN02255
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License Number State | RI
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