Provider Demographics
NPI:1194853416
Name:ROSEN, ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:ROSEN
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 1:650 CENTRAL AVE STE O
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2301
Mailing Address - Country:US
Mailing Address - Phone:516-569-2666
Mailing Address - Fax:
Practice Address - Street 1:650 CENTRAL AVE STE O
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2301
Practice Address - Country:US
Practice Address - Phone:516-569-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0368161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice