Provider Demographics
NPI:1407839244
Name:HELLER, ALAN R (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:HELLER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9811 MALLARD DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3199
Mailing Address - Country:US
Mailing Address - Phone:301-490-2882
Mailing Address - Fax:240-800-6200
Practice Address - Street 1:9811 MALLARD DR STE 201
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3199
Practice Address - Country:US
Practice Address - Phone:301-490-2882
Practice Address - Fax:240-800-6200
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD109111223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics