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General NPI Number Information
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NPI Number | 1962533588
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Entity Type | Organization
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Legal Business Name | FALLS DENTAL GROUP LLC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | N88W17001 MAIN ST
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2828
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Country | US
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Telephone | 262-251-6070
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Fax | 262-250-9000
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Provider Business Mailing Address
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Address Line | N88W17001 MAIN ST
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2828
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Country | US
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Telephone | 262-251-6070
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Fax | 262-250-9000
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Authorized Official
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Title or Position | OWNER
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Name | DR. N. GENE PITTMAN
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Credential | D.D.S.
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Telephone | 262-251-6070
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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