Provider Demographics
NPI:1780689760
Name:ALDER, BYRON D (DDS)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:D
Last Name:ALDER
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 1:175 S EL MOLINO AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2564
Mailing Address - Country:US
Mailing Address - Phone:626-792-3903
Mailing Address - Fax:
Practice Address - Street 1:175 S. EL MOLINO AVE
Practice Address - Street 2:STE 2
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2564
Practice Address - Country:US
Practice Address - Phone:626-792-3903
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
CA307861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice