Provider Demographics
NPI:1528083839
Name:YOUNG, ALAN P (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:P
Last Name:YOUNG
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 1:1404 3RD ST. SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677
Mailing Address - Country:US
Mailing Address - Phone:319-352-6600
Mailing Address - Fax:319-352-6605
Practice Address - Street 1:1404 3RD ST. SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677
Practice Address - Country:US
Practice Address - Phone:319-352-6600
Practice Address - Fax:319-352-6605
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA77751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7775OtherSTATE DENTAL LISCENSE
IA1130120Medicare ID - Type UnspecifiedIOWA MEDICAID #