Provider Demographics
NPI:1790019412
Name:FALMOUTH DENTAL GROUP
Entity Type:Organization
Organization Name:FALMOUTH DENTAL GROUP
Other - Org Name:ADVANCED DENTAL CARE OF FALMOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-548-5028
Mailing Address - Street 1:245 JONES RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2944
Mailing Address - Country:US
Mailing Address - Phone:508-548-5028
Mailing Address - Fax:508-548-7028
Practice Address - Street 1:245 JONES RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2944
Practice Address - Country:US
Practice Address - Phone:508-548-5028
Practice Address - Fax:508-548-7028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty