Provider Demographics
NPI:1235285172
Name:GROSS, ALLAN DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:DAVID
Last Name:GROSS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9685 ISLES CAY DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-9647
Mailing Address - Country:US
Mailing Address - Phone:954-830-8360
Mailing Address - Fax:561-210-4749
Practice Address - Street 1:6063 SW 18TH ST
Practice Address - Street 2:STE. 109
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7118
Practice Address - Country:US
Practice Address - Phone:561-394-5800
Practice Address - Fax:561-210-4759
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN 75031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice