Provider Demographics
NPI:1063749646
Name:GASTEIER, ALAN CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:CRAIG
Last Name:GASTEIER
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 1:315 WHITFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1669
Mailing Address - Country:US
Mailing Address - Phone:630-232-6503
Mailing Address - Fax:
Practice Address - Street 1:215 W WILSON ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1946
Practice Address - Country:US
Practice Address - Phone:630-879-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019A-145641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice