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General NPI Number Information
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NPI Number | 1306404959
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Entity Type | Individual
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Provider Name | ALAN GEORGE
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Gender | Male
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | US ARMY DENTAC 9900 LINCOLN STREET, 2ND FLOOR
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City | TACOMA
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State | WA
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Zip | 98327
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Country | US
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Telephone | 253-698-4079
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Fax | 253-968-5919
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Provider Business Mailing Address
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Address Line | 320 E HOSPITAL RD US ARMY DENTAC
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City | FT GORDON
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State | GA
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Zip | 30905
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Country | US
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Telephone | 614-266-4307
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.025814
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License Number State | OH
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