Provider Demographics
NPI:1134418353
Name:JOHN M FALACE, DMD
Entity type:Organization
Organization Name:JOHN M FALACE, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FALACE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-268-2332
Mailing Address - Street 1:620 PERIMETER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4125
Mailing Address - Country:US
Mailing Address - Phone:859-268-2332
Mailing Address - Fax:859-268-8746
Practice Address - Street 1:620 PERIMETER DR
Practice Address - Street 2:STE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4125
Practice Address - Country:US
Practice Address - Phone:859-268-2332
Practice Address - Fax:859-268-8746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty