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DR. MARK FALLON D.M.D,

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1780738542

Individual Registrant:
DR. MARK  FALLON D.M.D,
Gender: M
Not Sole Proprietor

Location and contact information for practice:
117 COW HILL RD  MYSTIC, CT 06355-1449 US
Tel: 860-536-4951  Fax: 860-572-1409

Contact information for business:
117 COW HILL RD  MYSTIC, CT 06355-1449 US
Tel: 860-536-4951  Fax: 860-572-1409

Registration Information:
NPI: 1780738542
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CT6346

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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