Provider Demographics
NPI:1417974486
Name:KELIHER, ALAN EDMUND (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:EDMUND
Last Name:KELIHER
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 1:36 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:978-774-3331
Mailing Address - Fax:978-774-3331
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:978-774-3331
Practice Address - Fax:978-774-3331
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11235122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist