Provider Demographics
NPI:1215142732
Name:MCHAN, ALAN PAUL (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:PAUL
Last Name:MCHAN
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 1:107 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-2041
Mailing Address - Country:US
Mailing Address - Phone:706-629-9412
Mailing Address - Fax:
Practice Address - Street 1:120 KING ST N
Practice Address - Street 2:SUITE 2
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-1844
Practice Address - Country:US
Practice Address - Phone:706-629-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA112191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice