Provider Demographics
NPI:1174941397
Name:PETRASZKO, ALEXANDRA MICHELLE (DDS)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MICHELLE
Last Name:PETRASZKO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8305 FALLS OF NEUSE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3546
Mailing Address - Country:US
Mailing Address - Phone:919-841-1720
Mailing Address - Fax:
Practice Address - Street 1:8305 FALLS OF NEUSE RD STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3546
Practice Address - Country:US
Practice Address - Phone:919-841-1720
Practice Address - Fax:919-841-1725
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC003531223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology