Provider Demographics
NPI:1679644793
Name:KRAKORA, ALAN TERENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:TERENCE
Last Name:KRAKORA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALAN
Other - Middle Name:TERENCE
Other - Last Name:KRAKORA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3457 RFD
Mailing Address - Street 2:
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047-8381
Mailing Address - Country:US
Mailing Address - Phone:847-438-3949
Mailing Address - Fax:
Practice Address - Street 1:4 S NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6231
Practice Address - Country:US
Practice Address - Phone:847-358-7282
Practice Address - Fax:847-991-1559
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice