Provider Demographics
NPI:1063613602
Name:MELTZER, ALAN M (DMD, MSCD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:MELTZER
Suffix:
Gender:M
Credentials:DMD, MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1307 WHITE HORSE RD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2176
Mailing Address - Country:US
Mailing Address - Phone:856-772-9444
Mailing Address - Fax:856-772-2325
Practice Address - Street 1:1307 WHITE HORSE RD
Practice Address - Street 2:BUILDING B
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2176
Practice Address - Country:US
Practice Address - Phone:856-772-9444
Practice Address - Fax:856-772-2325
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018710L1223P0300X
NJ22D1009236001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics