Provider Demographics
NPI:1790213759
Name:FALCON, HORACIO ENRIQUE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HORACIO
Middle Name:ENRIQUE
Last Name:FALCON
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 1:20690 VERNIER RD
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1415
Mailing Address - Country:US
Mailing Address - Phone:313-884-3050
Mailing Address - Fax:313-884-0007
Practice Address - Street 1:20690 VERNIER RD
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225
Practice Address - Country:US
Practice Address - Phone:313-884-3050
Practice Address - Fax:313-884-0007
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist