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General NPI Number Information
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NPI Number | 1821165259
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Entity Type | Individual
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Provider Name | LAURA SUSAN FALSETTI DMD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | US ARMY DENTAL ACTIVITY FORT LEWIS BLDG 9900, LINCOLN STREET
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 814-571-1126
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Fax |
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Provider Business Mailing Address
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Address Line | 1778 MCLEOD CIR
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City | DUPONT
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State | WA
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Zip | 98327-9793
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Country | US
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Telephone | 814-571-1126
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS027584L
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License Number State | PA
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