Provider Demographics
NPI:1265585822
Name:SELTZER, ALAN JEFFREY (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JEFFREY
Last Name:SELTZER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2601
Mailing Address - Country:US
Mailing Address - Phone:607-733-6825
Mailing Address - Fax:
Practice Address - Street 1:311 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2601
Practice Address - Country:US
Practice Address - Phone:607-733-6825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33631-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice