Provider Demographics
NPI:1265446645
Name:GAUCHMAN, ALAN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:H
Last Name:GAUCHMAN
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 1:88 POND ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067
Mailing Address - Country:US
Mailing Address - Phone:781-784-3880
Mailing Address - Fax:
Practice Address - Street 1:88 POND ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067
Practice Address - Country:US
Practice Address - Phone:781-784-3880
Practice Address - Fax:701-784-3223
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA122151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
X08002OtherBCBS OF MA
MA0261025Medicaid