Provider Demographics
NPI:1689606139
Name:METZGER, ALAN WAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:WAYNE
Last Name:METZGER
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 1:123 MOUNTAINVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-5709
Mailing Address - Country:US
Mailing Address - Phone:413-443-4217
Mailing Address - Fax:
Practice Address - Street 1:BERKSHIRE CMN
Practice Address - Street 2:SUITE 230
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6155
Practice Address - Country:US
Practice Address - Phone:413-448-8024
Practice Address - Fax:413-448-8208
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics