Provider Demographics
NPI:1174818595
Name:ALAN KELMAN, DDS, PA
Entity Type:Organization
Organization Name:ALAN KELMAN, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER OF ALAN KELMAN, DDS, PA
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:561-967-6453
Mailing Address - Street 1:5909 SOUTH CONGRESS AVENUE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462
Mailing Address - Country:US
Mailing Address - Phone:561-967-6453
Mailing Address - Fax:561-431-5866
Practice Address - Street 1:5909 SOUTH CONGRESS AVENUE
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-967-6453
Practice Address - Fax:561-431-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN170541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty