Provider Demographics
NPI:1194989061
Name:ALAN M FRIEDMAN DDS A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ALAN M FRIEDMAN DDS A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-477-8043
Mailing Address - Street 1:1990 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-8411
Mailing Address - Country:US
Mailing Address - Phone:310-477-8043
Mailing Address - Fax:310-474-5702
Practice Address - Street 1:1990 WESTWOOD BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8411
Practice Address - Country:US
Practice Address - Phone:310-477-8043
Practice Address - Fax:310-474-5702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty