Provider Demographics
NPI:1801154166
Name:FIERRO, ALAN G (DDS)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:G
Last Name:FIERRO
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 1:20406 REDWOOD RD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4317
Mailing Address - Country:US
Mailing Address - Phone:510-582-7919
Mailing Address - Fax:510-582-8745
Practice Address - Street 1:20406 REDWOOD RD
Practice Address - Street 2:SUITE C-1
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4317
Practice Address - Country:US
Practice Address - Phone:510-582-7919
Practice Address - Fax:510-582-8745
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250941223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health