Provider Demographics
NPI:1215548896
Name:PLAGENHOEF, ALEXANDER BRADEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:BRADEN
Last Name:PLAGENHOEF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-3228
Mailing Address - Country:US
Mailing Address - Phone:334-790-5152
Mailing Address - Fax:
Practice Address - Street 1:116 WATTERSON PKWY
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-2306
Practice Address - Country:US
Practice Address - Phone:205-655-7774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.0006798-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice