Provider Demographics
NPI:1013025246
Name:PAUL CHRISTIAN ALEXANDER
Entity Type:Organization
Organization Name:PAUL CHRISTIAN ALEXANDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMO PLLC
Authorized Official - Phone:928-474-3216
Mailing Address - Street 1:300 W AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541
Mailing Address - Country:US
Mailing Address - Phone:928-474-3216
Mailing Address - Fax:928-474-8369
Practice Address - Street 1:300 W AIRPORT RD
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541
Practice Address - Country:US
Practice Address - Phone:928-474-3216
Practice Address - Fax:928-474-8369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty