Provider Demographics
NPI:1578670170
Name:MINER, ALAN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:MINER
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 1:330 EAST 400 SOUTH
Mailing Address - Street 2:SUITE #4
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663
Mailing Address - Country:US
Mailing Address - Phone:801-489-4540
Mailing Address - Fax:801-489-9498
Practice Address - Street 1:330 EAST 400 SOUTH
Practice Address - Street 2:SUITE #4
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663
Practice Address - Country:US
Practice Address - Phone:801-489-4540
Practice Address - Fax:801-489-9498
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1371989922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist