Provider Demographics
NPI:1295453173
Name:FALCON DENTAL GROUP PLLC
Entity type:Organization
Organization Name:FALCON DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTISIT
Authorized Official - Prefix:DR
Authorized Official - First Name:HORACIO
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:FALCON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-884-3050
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:48225-1415
Practice Address - Country:US
Practice Address - Phone:313-884-3050
Practice Address - Fax:313-884-0007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty