Provider Demographics
NPI:1528417771
Name:ALAS, GINA
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:
Last Name:ALAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 68TH ST
Mailing Address - Street 2:US ARMY DENTAL ACTIVITY
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5042
Mailing Address - Country:US
Mailing Address - Phone:254-286-7401
Mailing Address - Fax:
Practice Address - Street 1:4431 68TH ST
Practice Address - Street 2:US ARMY DENTAL ACTIVITY
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5042
Practice Address - Country:US
Practice Address - Phone:254-286-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant