Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 17911 | MA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 2014 | VT |
NPI | 1457372278 |
---|---|
Provider Name | Alan C Garlick |
First Address | Greenfield, MA 01301 |
Second Address | Greenfield, MA 01301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U18363 | (02) |