Provider Demographics
NPI:1205002870
Name:FALCON, DENIS BERNARD (DMD)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:BERNARD
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 1:2299 9TH AVE N
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-6800
Mailing Address - Country:US
Mailing Address - Phone:727-321-6155
Mailing Address - Fax:727-323-6840
Practice Address - Street 1:2299 9TH AVE N
Practice Address - Street 2:SUITE 2-A
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-6800
Practice Address - Country:US
Practice Address - Phone:727-321-6155
Practice Address - Fax:727-323-6840
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN-96011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice