Provider Demographics
NPI:1548578172
Name:STEIN, ALAN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JOSEPH
Last Name:STEIN
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 1:550 EDWARDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:IL
Mailing Address - Zip Code:62294-1338
Mailing Address - Country:US
Mailing Address - Phone:618-667-3446
Mailing Address - Fax:618-667-4141
Practice Address - Street 1:550 EDWARDSVILLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294-1338
Practice Address - Country:US
Practice Address - Phone:618-667-3446
Practice Address - Fax:618-667-4141
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019016230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist