Provider Demographics
NPI:1861639130
Name:JURIM, ALAN JACOB (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JACOB
Last Name:JURIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CUTTERMILL RD
Mailing Address - Street 2:SUITE 270S
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:98 CUTTERMILL RD
Practice Address - Street 2:SUITE 270S
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3006
Practice Address - Country:US
Practice Address - Phone:516-562-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist