Provider Demographics
NPI:1013204601
Name:ROMERO DELMASTRO, ALEJANDRO ALBERTO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:ALBERTO
Last Name:ROMERO DELMASTRO
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 1:402 S OAKWOOD RD STE A
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-4945
Mailing Address - Country:US
Mailing Address - Phone:580-233-2557
Mailing Address - Fax:580-233-2563
Practice Address - Street 1:402 S OAKWOOD RD STE A
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-4945
Practice Address - Country:US
Practice Address - Phone:580-233-2557
Practice Address - Fax:580-233-2563
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2019-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3521223X0400X
OK1961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics