Individual
DR. ALAN NATHANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2578 ORTHODOX ST, PHILA, PA 19137-1636
(215) 533-7175
(215) 533-6026
Mailing address
2578 ORTHODOX ST, PHILADELPHIA, PA 19137-1636
(215) 533-7175
(215) 533-6026
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS021460L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232440843
FED TAX ID
PA
Enumeration date
01/10/2006
Last updated
09/13/2011
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