Provider Demographics
NPI:1073785093
Name:RODRICK ALSTON II, DDS, PA
Entity Type:Organization
Organization Name:RODRICK ALSTON II, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODRICK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-844-2250
Mailing Address - Street 1:9201 LEESVILLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7540
Mailing Address - Country:US
Mailing Address - Phone:919-844-2250
Mailing Address - Fax:919-844-2251
Practice Address - Street 1:9201 LEESVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7540
Practice Address - Country:US
Practice Address - Phone:919-844-2250
Practice Address - Fax:919-844-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6647261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental