Provider Demographics
NPI:1306932454
Name:SIZEMORE, ALAN L (DDS)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:SIZEMORE
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 1:501 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3054
Mailing Address - Country:US
Mailing Address - Phone:863-293-1108
Mailing Address - Fax:863-291-6319
Practice Address - Street 1:501 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3054
Practice Address - Country:US
Practice Address - Phone:863-293-1108
Practice Address - Fax:863-291-6319
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice