Provider Demographics
NPI:1235306168
Name:MINCER, ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:MINCER
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 1:1401 W DUNDEE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4055
Mailing Address - Country:US
Mailing Address - Phone:847-577-7771
Mailing Address - Fax:847-577-1720
Practice Address - Street 1:1401 W DUNDEE RD
Practice Address - Street 2:STE. 200
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4055
Practice Address - Country:US
Practice Address - Phone:847-577-7771
Practice Address - Fax:847-577-1720
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190187011223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics