Provider Demographics
NPI:1902959901
Name:MONTIEL, ALAIN ANDREA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAIN
Middle Name:ANDREA
Last Name:MONTIEL
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 1:1801 CLEMENT AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1378
Mailing Address - Country:US
Mailing Address - Phone:510-865-6088
Mailing Address - Fax:510-865-7634
Practice Address - Street 1:1801 CLEMENT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1378
Practice Address - Country:US
Practice Address - Phone:510-865-6088
Practice Address - Fax:510-865-7634
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB293841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice