Provider Demographics
NPI:1235240656
Name:GOLD, ALAN ELLIOT (DDS)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:ELLIOT
Last Name:GOLD
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 1:133 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446
Mailing Address - Country:US
Mailing Address - Phone:201-327-1311
Mailing Address - Fax:201-818-5096
Practice Address - Street 1:133 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446
Practice Address - Country:US
Practice Address - Phone:201-327-1311
Practice Address - Fax:201-818-5096
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ95571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice