Provider Demographics
NPI:1972798817
Name:ALAN PERSONS DMD, PC
Entity Type:Organization
Organization Name:ALAN PERSONS DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PERSONS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-435-0553
Mailing Address - Street 1:8811 N 51ST AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4949
Mailing Address - Country:US
Mailing Address - Phone:623-435-0553
Mailing Address - Fax:
Practice Address - Street 1:8811 N 51ST AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4949
Practice Address - Country:US
Practice Address - Phone:623-435-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD32281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty