Provider Demographics
NPI:1255501813
Name:ALAN R NEEFE DDS
Entity Type:Organization
Organization Name:ALAN R NEEFE DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-454-1616
Mailing Address - Street 1:1600 GILMORE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-2172
Mailing Address - Country:US
Mailing Address - Phone:507-454-1616
Mailing Address - Fax:507-454-8920
Practice Address - Street 1:1600 GILMORE AVE STE 200
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-2172
Practice Address - Country:US
Practice Address - Phone:507-454-1616
Practice Address - Fax:507-454-8920
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAN R NEEFE DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND10814122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty