Provider Demographics
NPI:1558476838
Name:LEVIN, ALAN C (BDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:LEVIN
Suffix:
Gender:M
Credentials:BDS
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Mailing Address - Street 1:3440 CONWAY BLVD
Mailing Address - Street 2:#2A
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-7000
Mailing Address - Country:US
Mailing Address - Phone:941-629-4311
Mailing Address - Fax:941-629-8930
Practice Address - Street 1:3440 CONWAY BLVD
Practice Address - Street 2:#2A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-7000
Practice Address - Country:US
Practice Address - Phone:941-629-4311
Practice Address - Fax:941-629-8930
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL82141223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics