Provider Demographics
NPI:1225607104
Name:FLORA, ALEXANDRIA (DMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:FLORA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E COLORADO AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3847
Mailing Address - Country:US
Mailing Address - Phone:317-750-9952
Mailing Address - Fax:
Practice Address - Street 1:729 W US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1603
Practice Address - Country:US
Practice Address - Phone:317-750-9952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist