Provider Demographics
NPI:1235264391
Name:BUCHALTER, ALYSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALYSON
Middle Name:
Last Name:BUCHALTER
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 1:388 AVENUE X
Mailing Address - Street 2:SUITE 1J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6051
Mailing Address - Country:US
Mailing Address - Phone:718-336-0450
Mailing Address - Fax:718-336-0450
Practice Address - Street 1:388 AVENUE X
Practice Address - Street 2:SUITE 1J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6051
Practice Address - Country:US
Practice Address - Phone:718-336-0450
Practice Address - Fax:718-336-0450
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0363881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice