Provider Demographics
NPI:1104013341
Name:ALSPACH, KENNETH ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ANTHONY
Last Name:ALSPACH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 GEORGES RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-1546
Mailing Address - Country:US
Mailing Address - Phone:732-329-3113
Mailing Address - Fax:732-329-2889
Practice Address - Street 1:338 GEORGES RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-1546
Practice Address - Country:US
Practice Address - Phone:732-329-3113
Practice Address - Fax:732-329-2889
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01431400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist