Individual
DR. ALEXANDER TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26 BROADWAY STE 1303, NEW YORK, NY 10004-1822
(917) 868-1552
Mailing address
26 BROADWAY STE 1303, NEW YORK, NY 10004-1822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
13151
CT
1223G0001X
General Practice Dentistry
Primary
061924
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2020
Last updated
05/10/2024
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