Provider Demographics
NPI:1932236882
Name:FALCON, EDGARDO ANTONIO JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:ANTONIO
Last Name:FALCON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-276-0297
Mailing Address - Fax:310-276-9758
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:SUITE 610
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-276-0297
Practice Address - Fax:310-276-9758
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA488061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice