Provider Demographics
NPI:1174664668
Name:FALCON, PAUL ALBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALBERT
Last Name:FALCON
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 1:95 SPARTA AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2619
Mailing Address - Country:US
Mailing Address - Phone:973-383-5610
Mailing Address - Fax:
Practice Address - Street 1:95 SPARTA AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2619
Practice Address - Country:US
Practice Address - Phone:973-383-5610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ130471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics