Healthcare Provider Details

I. General information

NPI: 1285740779
Provider Name (Legal Business Name): ALAN KIRSCH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N YORK RD
HATBORO PA
19040
US

IV. Provider business mailing address

444 N YORK RD
HATBORO PA
19040
US

V. Phone/Fax

Practice location:
  • Phone: 215-674-5383
  • Fax: 215-672-6352
Mailing address:
  • Phone: 215-674-5383
  • Fax: 215-672-6352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS016737
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: