Provider Demographics
NPI:1093729469
Name:MERCHANTHOUSE, ALAN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:E
Last Name:MERCHANTHOUSE
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 1:66 BLISS ST
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1902
Mailing Address - Country:US
Mailing Address - Phone:508-252-4774
Mailing Address - Fax:
Practice Address - Street 1:66 BLISS ST
Practice Address - Street 2:
Practice Address - City:REHOBOTH
Practice Address - State:MA
Practice Address - Zip Code:02769-1902
Practice Address - Country:US
Practice Address - Phone:508-252-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice