Provider Demographics
NPI:1306901863
Name:FALK, DENNIS RONALD (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RONALD
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 1:1275 W SHAW AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3710
Mailing Address - Country:US
Mailing Address - Phone:559-229-2313
Mailing Address - Fax:559-229-5410
Practice Address - Street 1:1275 W SHAW AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3710
Practice Address - Country:US
Practice Address - Phone:559-229-2313
Practice Address - Fax:559-229-5410
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice