Provider Demographics
NPI:1912092164
Name:DEAN, GEOFFERY ALAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFERY
Middle Name:ALAN
Last Name:DEAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 HIGHWAY 20 W
Mailing Address - Street 2:STE 2
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-3612
Mailing Address - Country:US
Mailing Address - Phone:256-895-0905
Mailing Address - Fax:
Practice Address - Street 1:7736 HIGHWAY 20 W
Practice Address - Street 2:STE 2
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-3612
Practice Address - Country:US
Practice Address - Phone:256-895-0905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice