Provider Demographics
NPI:1336331776
Name:DR. ALAN M. OGRADY DDS PC
Entity Type:Organization
Organization Name:DR. ALAN M. OGRADY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:OGRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-777-1670
Mailing Address - Street 1:36 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2954
Mailing Address - Country:US
Mailing Address - Phone:978-777-1670
Mailing Address - Fax:978-777-1685
Practice Address - Street 1:36 CONANT ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2954
Practice Address - Country:US
Practice Address - Phone:978-777-1670
Practice Address - Fax:978-777-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA120671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty