Provider Demographics
NPI:1275612996
Name:STOTT, ALAN L (DDS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:STOTT
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 1:44439 17TH ST W
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2831
Mailing Address - Country:US
Mailing Address - Phone:661-945-2733
Mailing Address - Fax:661-945-1314
Practice Address - Street 1:44439 17TH ST W
Practice Address - Street 2:SUITE 204
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2831
Practice Address - Country:US
Practice Address - Phone:661-945-2733
Practice Address - Fax:661-945-1314
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0276951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice