Provider Demographics
NPI:1083789325
Name:ALAN P BRANCH DMD PC
Entity Type:Organization
Organization Name:ALAN P BRANCH DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-584-3741
Mailing Address - Street 1:51 LOCUST STREET
Mailing Address - Street 2:SUITE 42
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2045
Mailing Address - Country:US
Mailing Address - Phone:413-584-3741
Mailing Address - Fax:413-582-0485
Practice Address - Street 1:51 LOCUST STREET
Practice Address - Street 2:SUITE 42
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2045
Practice Address - Country:US
Practice Address - Phone:413-584-3741
Practice Address - Fax:413-582-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA128821223G0001X
MA153011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty