Provider Demographics
NPI:1033384326
Name:ALEXANDER R. MCGEOCH, DDS, APC
Entity Type:Organization
Organization Name:ALEXANDER R. MCGEOCH, DDS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCGEOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:707-263-5427
Mailing Address - Street 1:1870 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-3615
Mailing Address - Country:US
Mailing Address - Phone:707-263-5427
Mailing Address - Fax:707-263-3925
Practice Address - Street 1:1870 N HIGH ST
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-3615
Practice Address - Country:US
Practice Address - Phone:707-263-5427
Practice Address - Fax:707-263-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29368261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental