Provider Demographics
NPI:1255437760
Name:ROSENFELD, ALAN L (DDS, FACD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:L
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:DDS, FACD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1S224 SUMMIT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3983
Mailing Address - Country:US
Mailing Address - Phone:630-627-3930
Mailing Address - Fax:630-627-2148
Practice Address - Street 1:1S224 SUMMIT AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3983
Practice Address - Country:US
Practice Address - Phone:630-627-3930
Practice Address - Fax:630-627-2148
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0149721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics