MEDICARE: DR. DONALD A FALACE DMD

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	122300000X	Dentist	3914	KY
2	1223G0001X	General Practice Dentistry	3914	KY

General Provider Information

NPI Number	:	1871693036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD A FALACE DMD

Provider Business Mailing Address
First Line	:	620 PERIMETER DR
Second Line	:	SUITE 200
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4125
Country	:	US
Telephone Number	:	859-268-2332
Fax Number	:	859-268-8746

Provider Business Practice Location Address
First Line	:	620 PERIMETER DR
Second Line	:	SUITE 200
City	:	LEXINGTON
State	:	KY
Zip	:	40517-4125
Country	:	US
Telephone Number	:	859-268-2332
Fax Number	:	859-268-8746

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/02/2010

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