Provider Demographics
NPI:1588684070
Name:GEORGE ALEXANDER,DDS,PA
Entity Type:Organization
Organization Name:GEORGE ALEXANDER,DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-435-6669
Mailing Address - Street 1:1629 HARDING BLVD
Mailing Address - Street 2:
Mailing Address - City:COTTER
Mailing Address - State:AR
Mailing Address - Zip Code:72626-9770
Mailing Address - Country:US
Mailing Address - Phone:870-435-6669
Mailing Address - Fax:870-435-2191
Practice Address - Street 1:1629 HARDING BLVD
Practice Address - Street 2:
Practice Address - City:COTTER
Practice Address - State:AR
Practice Address - Zip Code:72626-9770
Practice Address - Country:US
Practice Address - Phone:870-435-6669
Practice Address - Fax:870-435-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR28891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty