Provider Demographics
NPI:1053472324
Name:GEORGE L. ALISSANDRATOS, D.D.S., P.C.
Entity Type:Organization
Organization Name:GEORGE L. ALISSANDRATOS, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:LATTO
Authorized Official - Last Name:ALISSANDRATOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-459-4474
Mailing Address - Street 1:431 NISSAN DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-4365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:431 NISSAN DR STE 202
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4365
Practice Address - Country:US
Practice Address - Phone:615-459-4474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 2882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty