Provider Demographics
NPI:1033866959
Name:FALASZ, ADAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:FALASZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12310 WINDSOR WEST DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3039
Mailing Address - Country:US
Mailing Address - Phone:309-531-4871
Mailing Address - Fax:
Practice Address - Street 1:2005 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2746
Practice Address - Country:US
Practice Address - Phone:219-531-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0327701223G0001X
IN12013534A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice