Provider Demographics
NPI:1285867978
Name:LEE J. ALEXANDER, DMD
Entity Type:Organization
Organization Name:LEE J. ALEXANDER, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-463-7972
Mailing Address - Street 1:113 SW 11TH CT STE A
Mailing Address - Street 2:
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:954-764-5916
Practice Address - Street 1:113 SW 11TH CT STE A
Practice Address - Street 2:
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:954-764-5916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN75261223G0001X
FLDN166361223G0001X
FLDN188171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty