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Individual

DR. DREW WAYNE FALLIS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
2200 BERGQUIST DR STE 1, ATTN: DARLON JACKSON, CREDENTIALS MANAGER, LACKLAND A F B, TX 78236-9908
(210) 292-7395
(210) 292-7964
Mailing address
8610 MANTANO RDG, HELOTES, TX 78023-4705
(210) 372-0777
(210) 292-5935

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4870
OK

Other

Enumeration date
07/24/2006
Last updated
07/08/2007
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