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DR. MARK FALLON D.M.D,
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1780738542
Individual Registrant:DR. MARK FALLON D.M.D,
Gender: M
Not Sole Proprietor
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
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
Tel: 860-536-4951 Fax: 860-572-1409
Registration Information:
NPI: 1780738542
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | CT | 6346 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
