Provider Demographics
NPI:1528300597
Name:PAWL, ALAN DALE (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DALE
Last Name:PAWL
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 1:903 E DEL MAR BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3201
Mailing Address - Country:US
Mailing Address - Phone:626-792-6195
Mailing Address - Fax:626-792-8786
Practice Address - Street 1:903 E DEL MAR BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3201
Practice Address - Country:US
Practice Address - Phone:626-792-6195
Practice Address - Fax:626-792-8786
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0370011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice