Individual
MR. DALE P FALK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
W575 HIGHWAY 18, SULLIVAN, WI 53178-9520
(262) 593-2820
Mailing address
W575 HIGHWAY 18, SULLIVAN, WI 53178-9520
(262) 593-2820
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2284
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33394000
—
WI
Enumeration date
10/25/2005
Last updated
07/08/2007
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