Provider Demographics
NPI:1831312834
Name:BUDENZ, ALAN WYTHE (DDS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:WYTHE
Last Name:BUDENZ
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 1:2155 WEBSTER ST
Mailing Address - Street 2:UNIVERSITY OF THE PACIFIC, AAD SCHOOL OF DENTISTRY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2333
Mailing Address - Country:US
Mailing Address - Phone:415-929-6574
Mailing Address - Fax:415-749-3339
Practice Address - Street 1:2155 WEBSTER ST
Practice Address - Street 2:UNIVERSITY OF THE PACIFIC, AAD SCHOOL OF DENTISTRY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2333
Practice Address - Country:US
Practice Address - Phone:415-929-6574
Practice Address - Fax:415-749-3339
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA309081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice