Provider Demographics
NPI:1164666798
Name:DEUTSCH, ALICE B (DMD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:B
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 TREEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2413
Mailing Address - Country:US
Mailing Address - Phone:631-692-5280
Mailing Address - Fax:
Practice Address - Street 1:515 MADISON AVE
Practice Address - Street 2:SUITE 1212
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5403
Practice Address - Country:US
Practice Address - Phone:212-697-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist