Provider Demographics
NPI:1750365649
Name:FALK, BENJAMIN HARPER (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:HARPER
Last Name:FALK
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 1:41 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-4400
Mailing Address - Country:US
Mailing Address - Phone:413-586-0320
Mailing Address - Fax:413-584-6573
Practice Address - Street 1:41 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-4400
Practice Address - Country:US
Practice Address - Phone:413-586-0320
Practice Address - Fax:413-584-6573
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19624122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist