Provider Demographics
NPI:1376609222
Name:DOERING, ALAN CARL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:CARL
Last Name:DOERING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2450 44TH ST SE
Mailing Address - Street 2:STE 201
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49512-3802
Mailing Address - Country:US
Mailing Address - Phone:616-224-3636
Mailing Address - Fax:616-224-3644
Practice Address - Street 1:2450 44TH ST SE
Practice Address - Street 2:STE 201
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-3802
Practice Address - Country:US
Practice Address - Phone:616-224-3636
Practice Address - Fax:616-224-3644
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010130211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics