Provider Demographics
NPI:1255474730
Name:MYERS, ALAN JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAY
Last Name:MYERS
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 1:403 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2042
Mailing Address - Country:US
Mailing Address - Phone:330-343-2322
Mailing Address - Fax:330-364-1717
Practice Address - Street 1:403 MONROE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2042
Practice Address - Country:US
Practice Address - Phone:330-343-2322
Practice Address - Fax:330-364-1717
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist