Provider Demographics
NPI:1063901916
Name:FALK, BRIAN CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CRAIG
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 1:18 KERBY LN
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-2901
Mailing Address - Country:US
Mailing Address - Phone:973-219-5893
Mailing Address - Fax:
Practice Address - Street 1:1 WESCOTT DR STE 202
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4655
Practice Address - Country:US
Practice Address - Phone:908-788-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02706500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist