Provider Demographics
NPI:1790860468
Name:GOLDMAN, ALAN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:GOLDMAN
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 1:6660 PEACH ST
Mailing Address - Street 2:SUITE C-12
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-7718
Mailing Address - Country:US
Mailing Address - Phone:814-866-1250
Mailing Address - Fax:
Practice Address - Street 1:6660 PEACH STREET
Practice Address - Street 2:SUITE C12 ALLCARE DENTAL & DENTURES PC
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509
Practice Address - Country:US
Practice Address - Phone:814-866-1250
Practice Address - Fax:814-866-7006
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025608L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist