Provider Demographics
NPI:1487615753
Name:RAUCHBERG, ALAN DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:RAUCHBERG
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 1:199 BALDWIN RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2043
Mailing Address - Country:US
Mailing Address - Phone:973-334-3777
Mailing Address - Fax:973-334-0856
Practice Address - Street 1:199 BALDWIN RD
Practice Address - Street 2:SUITE 120
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2043
Practice Address - Country:US
Practice Address - Phone:973-334-3777
Practice Address - Fax:973-334-0856
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI018513122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist