Provider Demographics
NPI:1003305251
Name:ALEXANDER, HANNAH ISABEL
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ISABEL
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 W VILLAGE PLACE
Mailing Address - Street 2:SUITE 2015
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:770-438-9558
Mailing Address - Fax:
Practice Address - Street 1:4500 W VILLAGE PL SE UNIT 2015
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-9245
Practice Address - Country:US
Practice Address - Phone:770-438-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015276122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist