Provider Demographics
NPI:1659187193
Name:MOLINA FALCO, MERLYN (DDS)
Entity type:Individual
Prefix:
First Name:MERLYN
Middle Name:
Last Name:MOLINA FALCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SAN CARLOS WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-1956
Mailing Address - Country:US
Mailing Address - Phone:209-536-8333
Mailing Address - Fax:
Practice Address - Street 1:2665 YALE AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-0813
Practice Address - Country:US
Practice Address - Phone:786-479-7439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty