Provider Demographics
NPI:1033199302
Name:LICHTER, JOSEPH ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALAN
Last Name:LICHTER
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 1:1420 AVENUE P FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1189
Mailing Address - Country:US
Mailing Address - Phone:718-339-7878
Mailing Address - Fax:718-339-6611
Practice Address - Street 1:1420 AVENUE P FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1189
Practice Address - Country:US
Practice Address - Phone:718-339-7878
Practice Address - Fax:718-339-6611
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist