Provider Demographics
NPI:1093703746
Name:MORITZ, ALAN JOHN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JOHN
Last Name:MORITZ
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 3865
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09126
Mailing Address - Country:DE
Mailing Address - Phone:004-965-6561
Mailing Address - Fax:8229
Practice Address - Street 1:UNIT 3865
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09126
Practice Address - Country:DE
Practice Address - Phone:004-965-6561
Practice Address - Fax:8229
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215331223P0300X
IL1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223P0300XDental ProvidersDentistPeriodontics