Provider Demographics
NPI:1790992022
Name:BRONER, ALAN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:BRONER
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 1:773 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-5278
Mailing Address - Country:US
Mailing Address - Phone:718-756-2626
Mailing Address - Fax:
Practice Address - Street 1:773 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-5278
Practice Address - Country:US
Practice Address - Phone:718-756-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297271223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics