Provider Demographics
NPI:1053070417
Name:FALMOUTH DENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:FALMOUTH DENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-781-2328
Mailing Address - Street 1:21 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1379
Mailing Address - Country:US
Mailing Address - Phone:207-781-2328
Mailing Address - Fax:
Practice Address - Street 1:21 NORTHBROOK DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1379
Practice Address - Country:US
Practice Address - Phone:207-781-2328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALMOUTH DENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty