Provider Demographics
NPI:1003014333
Name:GUY, ALAN MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARTIN
Last Name:GUY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6192
Mailing Address - Country:US
Mailing Address - Phone:407-856-0208
Mailing Address - Fax:
Practice Address - Street 1:4250 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6192
Practice Address - Country:US
Practice Address - Phone:407-856-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 53871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice