Provider Demographics
NPI:1871628669
Name:DAY, ALAN M (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:DAY
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:PO BOX 297
Mailing Address - Street 2:13794 FLORIDA BLVD
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-0297
Mailing Address - Country:US
Mailing Address - Phone:225-686-7464
Mailing Address - Fax:225-686-7465
Practice Address - Street 1:13794 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-0297
Practice Address - Country:US
Practice Address - Phone:225-686-7464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF1296OtherBLUE CROSS BLUE SHIELD
LA831008OtherUNITED CONCORDIA
LA1832707Medicaid