Individual
FALON DEAN WAISATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
530 N TELSHOR BLVD STE A, LAS CRUCES, NM 88011-8243
(216) 973-6445
Mailing address
PO BOX 21, PAONIA, CO 81428-0021
(970) 527-4853
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00202094
CO
Other
Enumeration date
04/21/2010
Last updated
11/12/2015
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