MEDICARE: DR. ALAN ELLOIT STERN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	31616	NY

General Provider Information

NPI Number	:	1376562124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN ELLOIT STERN DDS

Provider Business Mailing Address
First Line	:	409 BIRCH LN
Second Line	:
City	:	LEONIA
State	:	NJ
Zip	:	07605-1411
Country	:	US
Telephone Number	:	201-947-5741
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 BIRCH LN
Second Line	:
City	:	LEONIA
State	:	NJ
Zip	:	07605-1411
Country	:	US
Telephone Number	:	201-679-4924
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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