Provider Demographics
NPI:1639285828
Name:BURCH, ALAN IRWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:IRWIN
Last Name:BURCH
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 1:19495 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180
Mailing Address - Country:US
Mailing Address - Phone:305-931-8255
Mailing Address - Fax:305-936-5971
Practice Address - Street 1:19495 BISCAYNE BLVD
Practice Address - Street 2:SUITE 406
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-931-8255
Practice Address - Fax:305-936-5971
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 45331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice