Provider Demographics
NPI:1578851804
Name:LAPRATT, ALAN ROY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROY
Last Name:LAPRATT
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 1:5895 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-6961
Mailing Address - Country:US
Mailing Address - Phone:541-844-3113
Mailing Address - Fax:
Practice Address - Street 1:5895 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-6961
Practice Address - Country:US
Practice Address - Phone:541-844-3113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27320122300000X
ORD111191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist