Provider Demographics
NPI:1841590882
Name:TOPHAM, ALAN LEWIS (DDS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:LEWIS
Last Name:TOPHAM
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 1:940 FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4722
Mailing Address - Country:US
Mailing Address - Phone:469-297-4618
Mailing Address - Fax:
Practice Address - Street 1:4500 S. LANCASTER RD.
Practice Address - Street 2:VA NORTH TEXAS HEALTH CARE DENTAL SERVICE (160)
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:214-857-1082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26061OtherTEXAS BOARD OF DENTAL EXAMINERS