Provider Demographics
NPI:1447670716
Name:WHISPERING CREEK DENTAL CARE
Entity type:Organization
Organization Name:WHISPERING CREEK DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:FALVO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-374-1758
Mailing Address - Street 1:5915 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3624
Mailing Address - Country:US
Mailing Address - Phone:734-357-8999
Mailing Address - Fax:
Practice Address - Street 1:5915 N LILLEY RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3624
Practice Address - Country:US
Practice Address - Phone:734-357-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010110381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty