MEDICARE: DR. WILLIAM V. FALK D.M.D.M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	30-16281	OH

General Provider Information

NPI Number	:	1124171640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM V. FALK D.M.D.M.S.

Provider Business Mailing Address
First Line	:	1740 COOPER FOSTER PARK RD W
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44053-4201
Country	:	US
Telephone Number	:	440-960-2970
Fax Number	:	440-960-6935

Provider Business Practice Location Address
First Line	:	1740 COOPER FOSTER PARK RD W
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44053-4201
Country	:	US
Telephone Number	:	440-960-2970
Fax Number	:	440-960-6935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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