Provider Demographics
NPI:1396754974
Name:BAUER, ALAN JEFFRY (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JEFFRY
Last Name:BAUER
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 1:1730 CENTRAL PARK AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4905
Mailing Address - Country:US
Mailing Address - Phone:914-423-1111
Mailing Address - Fax:914-395-0101
Practice Address - Street 1:1730 CENTRAL PARK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4905
Practice Address - Country:US
Practice Address - Phone:914-423-1111
Practice Address - Fax:914-395-0101
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0290341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice