Provider Demographics
NPI:1265661144
Name:ALEXANDER, ALLISON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:ALEXANDER
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 1:113 SW 11TH CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-1271
Mailing Address - Country:US
Mailing Address - Phone:954-463-7972
Mailing Address - Fax:
Practice Address - Street 1:113 SW 11TH CT
Practice Address - Street 2:SUITE A
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-1271
Practice Address - Country:US
Practice Address - Phone:954-463-7972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN188171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice