Provider Demographics
NPI:1922440445
Name:FALCONE, SAMUEL ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ANTHONY
Last Name:FALCONE
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 1:2 W WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-1838
Mailing Address - Country:US
Mailing Address - Phone:570-655-3781
Mailing Address - Fax:570-655-3782
Practice Address - Street 1:2 W WILLIAM ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-1838
Practice Address - Country:US
Practice Address - Phone:570-655-3781
Practice Address - Fax:570-655-3782
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS181276L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist