MEDICARE: DR. ALAN STEVEN GOLD 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	15765	MA

General Provider Information

NPI Number	:	1861466351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN STEVEN GOLD DDS

Provider Business Mailing Address
First Line	:	515 SOUTH ST
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-8203
Country	:	US
Telephone Number	:	413-443-3144
Fax Number	:	413-443-3806

Provider Business Practice Location Address
First Line	:	515 SOUTH ST
Second Line	:
City	:	PITTSFIELD
State	:	MA
Zip	:	01201-8203
Country	:	US
Telephone Number	:	413-443-3144
Fax Number	:	413-443-3806

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	07/08/2007

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