Provider Demographics
NPI:1518960582
Name:FRIEDEL, ALAN ERIC (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ERIC
Last Name:FRIEDEL
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 1:1329 POLK ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-1036
Mailing Address - Country:US
Mailing Address - Phone:954-925-5250
Mailing Address - Fax:954-454-1902
Practice Address - Street 1:660 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4422
Practice Address - Country:US
Practice Address - Phone:954-454-4446
Practice Address - Fax:954-454-1902
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL67359OtherBCBS
PA433323OtherBCBS
PA433323OtherBCBS
FL67359OtherBCBS