Provider Demographics
NPI:1598881237
Name:AVTGES, ALAN J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:AVTGES
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 1:3 FUNDY RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1796
Mailing Address - Country:US
Mailing Address - Phone:207-781-2054
Mailing Address - Fax:207-781-7133
Practice Address - Street 1:3 FUNDY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1796
Practice Address - Country:US
Practice Address - Phone:207-781-2054
Practice Address - Fax:207-781-7133
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME31741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice