Provider Demographics
NPI:1083050405
Name:FALLER, JOHN ADAMS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADAMS
Last Name:FALLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8847 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-7707
Mailing Address - Country:US
Mailing Address - Phone:504-230-0329
Mailing Address - Fax:504-466-2399
Practice Address - Street 1:8847 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-7707
Practice Address - Country:US
Practice Address - Phone:504-230-0329
Practice Address - Fax:504-466-2399
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA63831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice