Provider Demographics
NPI:1326792532
Name:ALEJANDRO PIEDRA DMD PA
Entity Type:Organization
Organization Name:ALEJANDRO PIEDRA DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST- OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:PIEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-682-0456
Mailing Address - Street 1:10640 GRIFFIN RD
Mailing Address - Street 2:UNIT 107
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328
Mailing Address - Country:US
Mailing Address - Phone:954-515-1473
Mailing Address - Fax:954-515-1474
Practice Address - Street 1:10640 GRIFFIN RD
Practice Address - Street 2:UNIT 107
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328
Practice Address - Country:US
Practice Address - Phone:954-515-1473
Practice Address - Fax:954-515-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty