Provider Demographics
NPI:1376562124
Name:STERN, ALAN ELLOIT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ELLOIT
Last Name:STERN
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 1:409 BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1411
Mailing Address - Country:US
Mailing Address - Phone:201-947-5741
Mailing Address - Fax:
Practice Address - Street 1:409 BIRCH LN
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-1411
Practice Address - Country:US
Practice Address - Phone:201-679-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice