Provider Demographics
NPI:1619100088
Name:DESABELLE, ALESSANDRA GOSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALESSANDRA
Middle Name:GOSE
Last Name:DESABELLE
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 1:1409 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-3708
Mailing Address - Country:US
Mailing Address - Phone:559-444-0444
Mailing Address - Fax:
Practice Address - Street 1:1409 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-3708
Practice Address - Country:US
Practice Address - Phone:559-444-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58737122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist