Provider Demographics
NPI:1407074396
Name:RICHTER, ALAN JEFFREY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JEFFREY
Last Name:RICHTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 ATLANTIC SHORES BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2507
Mailing Address - Country:US
Mailing Address - Phone:954-456-7900
Mailing Address - Fax:954-362-2404
Practice Address - Street 1:618 ATLANTIC SHORES BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2507
Practice Address - Country:US
Practice Address - Phone:954-456-7900
Practice Address - Fax:954-362-2404
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice