Provider Demographics
NPI:1093120107
Name:FOREST, ALEXANDRA (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:FOREST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CHARLES PLZ APT 1108
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4219
Mailing Address - Country:US
Mailing Address - Phone:734-730-7825
Mailing Address - Fax:
Practice Address - Street 1:8 CHARLES PLZ APT 1108
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4219
Practice Address - Country:US
Practice Address - Phone:734-730-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital