Provider Demographics
NPI:1497010458
Name:MALEBRANCHE, ALEXANDRA (DDS)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:MALEBRANCHE
Suffix:
Gender:F
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:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-0349
Mailing Address - Country:US
Mailing Address - Phone:098-453-0536
Mailing Address - Fax:
Practice Address - Street 1:693 MAIN STREET
Practice Address - Street 2:BUILDING B, SUITE 1
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048
Practice Address - Country:US
Practice Address - Phone:609-845-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0407401223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry