Provider Demographics
NPI:1386857365
Name:FINK, ALAN M (DDS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:M
Last Name:FINK
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 1:30423 CANWOOD STREET
Mailing Address - Street 2:SUITE #121
Mailing Address - City:AGOURA
Mailing Address - State:CA
Mailing Address - Zip Code:91301
Mailing Address - Country:US
Mailing Address - Phone:818-889-4220
Mailing Address - Fax:818-889-2338
Practice Address - Street 1:30423 CANWOOD STREET
Practice Address - Street 2:SUITE #121
Practice Address - City:AGOURA
Practice Address - State:CA
Practice Address - Zip Code:91301
Practice Address - Country:US
Practice Address - Phone:818-889-4220
Practice Address - Fax:818-889-2338
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA233001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice