Provider Demographics
NPI:1255401774
Name:FALBO, ANTHONY D (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:D
Last Name:FALBO
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 1:14245F CENTREVILLE SQ
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2368
Mailing Address - Country:US
Mailing Address - Phone:703-815-0775
Mailing Address - Fax:703-222-7557
Practice Address - Street 1:14245F CENTREVILLE SQ
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2368
Practice Address - Country:US
Practice Address - Phone:703-815-0775
Practice Address - Fax:703-222-7557
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice